• 제목/요약/키워드: swallowing

검색결과 613건 처리시간 0.025초

두경부암 환자에서 기도 흡인의 예방과 치료를 위한 수술 전략 (Surgical Strategies for Prevention and Treatment of Airway Aspiration in Head and Neck Cancer Patients)

  • 백민관;김동영
    • 대한후두음성언어의학회지
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    • 제29권1호
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    • pp.9-13
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    • 2018
  • Postoperative airway aspiration is not uncommon in patients with head and neck cancer. Airway aspiration has serious consequences, such as swallowing disorders, nutrition-related health problem, or reducing the quality of life due to maintenance of tracheal or nasogastric tubes. The postoperative oropharyngeal defect due to the surgery may interfere with normal swallowing reflex, or the laryngeal dysfunction caused by radiation therapy may cause severe airway aspiration, which may lead to complications such as dyspnea and pneumonia. Complete removal of the disease is also important in the treatment of head and neck cancer, but it is necessary to select a method to avoid and predict the occurrence of airway aspiration according to the treatment method. The most important factor to prevent airway aspiration after surgery is to preserve the proper volume of the oropharynx and to preserve at least one of the cricoarytenoid joint function. It is also the most effective way to reduce additional complications by seeking appropriate surgical treatment according to airway aspiration status. The purpose of this study is to review the operative methods that can induce airway aspiration and consider the prevention and treatment strategy through review of the literature.

설유착증 환자에서의 Z-Plasty를 이용한 치료증례 (TREATIMENT OF ANKYLOGLOSSIA USING Z-PLASTY TECHNIQUE: A CASE REPORT)

  • 이지영;김대업;이광희
    • 대한소아치과학회지
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    • 제23권3호
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    • pp.697-705
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    • 1996
  • Ankyloglossia, or tongue-tie, is a congenital condition which occurs as a result of fusion between the tongue and the floor of the mouth. Ankyloglossia often results in malocclusion with an anterior "open bite" deformity, early prognathism, swallowing problem, speech disorder, and periodontal problem. Generally lingual frenectomy is used for treatment of ankyloglossia, but incomplete operation and simple frenectomy may produce a scar contracture resulting in a more deformed ankyloglossia than was present initially. The Z-plasty is used for the correction of scar contractures and the replacement of missing tissue and this procedure is ideally suited for the treatment of an ankylosed frenum. Most authors advise postponement of any decision for surgical correction of tongue-tie until the age of 4 years, unless the child is having much difficulty with sucking or swallowing. We treated 4 patients with ankyloglossia using Z-plasty technique. As a result, we found out that it was effective for correction of movement limitation of tongue, prevention of relapse. Further, periodic check ups are needed for evaluation of relapse, improvement of speech, and other functions of the tongue.

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재활치료와 한방치료를 병행한 다발성 뇌신경계 위축증 1례 (Case of Multiple Systemic Atrophy Treated with Korean Medical Treatment and Rehabilitation Therapy)

  • 박장경;맹유숙;이승복;김동일
    • 대한한의학회지
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    • 제32권2호
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    • pp.118-125
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    • 2011
  • 난치성 질환인 다발성 뇌신경계 위축증으로 진단 받은 환자를 신음허, 비기허, 중풍으로 변증하고 한약 치료, 침구 치료 및 재활 치료를 시행한 결과 근력 및 연하기능이 호전된 경과를 관찰하였기에 보고하는 바이다. 향후 다발성 뇌신경계 위축증에 대한 한방치료 효과를 증명하기 위해 추가적인 증례 보고와 다양한 실험 및 임상연구가 필요할 것으로 사료된다.

측두하악 관절 장애의 평가 (Clinical Assessment of Temporomandibular Joint Dysfunction)

  • 류재관;김종순
    • 대한물리치료과학회지
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    • 제5권4호
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    • pp.717-728
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    • 1998
  • The Temporomandibural joint(TMJ) is one of the most frequently used joint in the body as $1,500{\sim}2,000$ times per day for the activities of chewing, swallowing, talking, yawing and sneezing. The TMJ are formed by condylar process of mandible and mandible fossa of temporal bone, separated by an articular disc. This articular disc divides into two cavities as upper cavity and lower cavity. The gliding movement occurs in the upper cavity of the joint, whereas hinge movement occurs in the lower cavity. The movements that are allowed at the TMJ are opening, closing, protrusion, retraction and lateral movement. A cause of TMJ dysfunction are capsulitis, internal derangement, osteoarthritis, rheumatoid arthritis, infection and inflammation near the joint, trauma on joint, ankylosis, subluxation or dislocation of joint, injury of articular disc, myositis, muscle contracture or spasm, myofascial pain dysfunction syndrome, dyskinesia of masticatory muscles, developmental abnormality, tumor, connective tissue disease, fibrosis, malocclusion, swallowing abnormality, wrong habits such as bite nail or hair, bruxism, psycological stress and Costen syndrome etc. Assessment of TMJ dysfunction consist of interview, observation, functional examination, palpation, reflex test, joint play test, electromyography and radiologic examination and behavioral and psycological assessment etc.

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폐렴 양방 치료 종료 후 지속되는 가래 및 연하장애를 주소로 하는 노인 환자의 시박탕(柴朴湯) 치험례 (A Case Report of Sibak-tang Effectiveness in an Elderly Patient with Sputum and Dysphagia after Conventional Treatment for Pneumonia)

  • 임보라;박영화;조준호;권도익
    • 대한한방내과학회지
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    • 제38권5호
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    • pp.753-762
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    • 2017
  • Objectives: We conducted this study to report the clinical effects of Sibak-tang (Saiboku-to) in an elderly patient suffering from sputum and dysphagia after conventional treatment for pneumonia. Methods: The Sibak-tang was administered to the patient to treat sputum and dysphagia. The results were assessed by measuring the frequency of the sputum and conducting a videofluoroscopic swallowing study. Results: After about three weeks of herbal medicine treatments, the patient's symptoms of respiratory problems improved. The results of the videofluoroscopic swallowing study were also improved. Conclusion: Sibak-tang could be an effective treatment for elderly patients suffering from sputum and dysphagia after conventional treatment for pneumonia.

뇌졸중 환자의 인두기능 회복을 위한 전기자극기 설계 (Electrical Stimulation System Design for Pharyngeal Dysfunction of Stroke Patients)

  • 유지혜;배하석;최병철;김성민
    • 한국정밀공학회지
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    • 제22권7호
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    • pp.185-190
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    • 2005
  • The purpose of this study is to design electrical stimulation system fur stroke patients with pharyngeal dysfunction(dysphagia). Dysphagia is that the food has trouble in passing to the mouth from the stomach. Although we have many treatment methods for dysphagia, electrical stimulation system will be useful for stroke patients having dysphagia. Electrical stimulation system can be divided into body and electrodes. The body stimulation is composed to frequency counter, time control and current measurement part. These parts are to control the frequency, stimulating time and current intensity And they can be variable according to the patient's clinical assessment. The electrode plays a role to deliver the current from the system to the muscle. Also the position of the electrode can be variable according to the treatment method. We performed the clinical experiment with stroke patients who had swallowing disorder. The videofluoroscopy was used fur the observation. From the result of clinical experiment based on electrical stimulation, we expected that the dysfunction(in pharynx) level of the patient could be improved. However we could not have enough effectiveness of the treatment because of the number of patients, patient's adaptation and treatment period. We will design the optimized electrical stimulation system based on enough clinical experiment in the future.

설근부에서 시작된 인후두협착과 식도협착 1례 (Complete laryngopharyngoesophageal stricture due to lye ingestion)

  • 최환;백승국;권순영;정광윤;김광택
    • 대한기관식도과학회지
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    • 제13권1호
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    • pp.55-58
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    • 2007
  • Caustic bums of the upper aerodigestive tract continue to be a significant clinical problem. Wide -field pharyngoesophagectomy is commonly performed as treatment for malignancies of the hypopharynx. A total laryngectomy is often necessary at the time of this procedure because of the anatomical proximity of the cancer or because of the likely compromise of swallowing postoperatively. When preservation of the larynx is attempted, aspirations after surgery frequently require a second-stage laryngectomy. And various flaps are using for reconstruction of esophageal defect. The choice of reconstruction is depended to the patient's status. A 54-year-old women whose symptom was severe dysphagia and X-ray revealed laryngopharyngeal stricuture. She had attempted suicide by swallowing lye liquids 32 years ago. She has entire laryngopharyngeal and esophageal stricutures. Total laryngectomy was performed and reconstruction of theesophagus was carried out with unusual reversed-gastric tube formation. Hence, we report this case with the review of literaturefor proper management in the future.

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Effect of Suprahyoid Muscle Resistance Exercise Using Kinesio Taping on Suprahyoid Muscle Thickness in Patients with Dysphagia after Subacute Stroke

  • Lee, Myunglyeol;Kim, Jinuk;Oh, Donghwan;Lee, Kuija
    • 국제물리치료학회지
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    • 제11권3호
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    • pp.2135-2139
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    • 2020
  • Background: Recently, a new method of dysphagia rehabilitation using Kinesio taping (KT) has been attempted and demonstrated an immediate increase in the activation of the suprahyoid muscle during swallowing in healthy adults. Objectives: To investigate the effect of dysphagia rehabilitation using KT on the thickness change of the suprahyoid muscle in patients with dysphagia after stroke. Design: Two-group pre-post design. Methods: In this study, 20 patients with dysphagia after stroke were enrolled and assigned to the experimental and control groups. The experimental group applied KT to the front of the neck and repeatedly swallowed against the tension of the tape. On the other hand, the control group performed repeated swallowing without applying KT. Patients in both groups had swallowed 50 times a day/5 times a week for 4 weeks. For evaluation, the volume of the geniohyoid, mylohyoid, and digastric muscle was measured before and after the intervention using portable ultrasound equipment. Results: As a result of comparing the two groups after the intervention, the experimental group showed more volume increase in mylohyoid (P<.05) and digastric muscle (P<.05) than the control group. Conclusion: This study proved that suprahyoid muscle resistance exercise using KT is effective in increasing the volume of the suprahyoid muscle.

Immunoglobulin으로 호전된 POEMS 증후군의 다발성 신경병증 1예 (A Case of Polyneuropathy of the POEMS Syndrome Responsive to Intravenous Immunoglobulin)

  • 배상우;권준우;윤숙;장윤정;이창민;이근호;김재일
    • Annals of Clinical Neurophysiology
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    • 제5권2호
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    • pp.210-213
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    • 2003
  • POEMS syndrome is a multisystem disorder associated with polyneuropathy, organomegaly, endocrinopathy, a monoclonal protein(M-protein), and skin change. Recently we have had the opportunity to attend one patient with clinical features similar to this syndrome. He was a 46-year-old man who had a progressive polyneuropathy, swallowing difficulty, hepatosplenomegaly, hypothyroidism, IgA ${\lambda}type$ monoclonal gammapathy, specific skin change and ascites. His symptoms such as low extrimity pain and weakness, swallowing difficulty were improved by high-dose 7S-IgG. Thus, we report a case with a review of the literature.

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연하곤란을 초래한 구인두부 신경초종 1례 (A Case of Oropharyngeal Neurilemmoma with Swallowing Difficulty.)

  • 심상열;양오규;백석인;윤강묵;박순일
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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    • pp.11.1-11
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    • 1981
  • 신경초종은 뇌 및 척수신경의 근부등 비교적 굵은 신경의 신경초로부터 발생하고 단발성이며 피막이 있는 양성 종양이다. 1908년 Verocay가 처음으로 Neurinoma라고 명명한 이래 Peripheral Fibroblastoma(Penfield, 1930) Peripheral Glioma, Neuroma 및 Schwannoma등의여러 명칭으로 불리게 되었으나 1935년 Stout에 의해 Neurilemmoma라고 명명하기에 이르렀다. 이 종양은 1955년 Conley에 의하면 신체의 어느 부위에나 발생하며 두경부에서 약 25% 이상이 나타나고 이비인후과영역에서는 청신경에 가장 많고 다음이 후두, 인두, 구강의 순으로 나타난다. 구인두의 양성 종양은 편평상피 유두종이 가장 많으며 드물게는 지방종, 섬유종, 연골종, 신경초종등이 나타날 수 있다. 구인두 신경초종은 주로 미주신경, 설하신경등 주위신경의 신경초에서 발생되며(Iliadeg and Wutson, 1967, 서서히 성장하므로 종물이 커지기 전에는 종물부 이물감, 압통외에는 특이한 증상이 없다. 저자들은 구인두 측벽에 4cm$\times$4cm$\times$5cm의 거대 종물로 연하곤란을 초래한 신경초종 1례를 치험하였기에 문헌 고찰과 함께 보고하는 바이다.

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