• 제목/요약/키워드: vocal cord

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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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일측 성대마비 환자의 보상기전에 관여하는 후두내근육 : PET-CT 융합 영상을 사용한 정상군과의 발성시 및 비발성시의 비교 (Hypermetabolism of Compensatory Laryngeal Muscles in Unilateral Vocal Cord Palsy: Comparison Study between Speech and Silence with Normal Subjects by Co-registered PET-CT Fusion Images)

  • 배문선;김현경;김한수
    • Nuclear Medicine and Molecular Imaging
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    • 제40권1호
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    • pp.23-27
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    • 2006
  • 목적: 일측성 성대마비 환자의 FDG-PET에서 영상 판독에 오류를 일으킬 수 있는 성대의 비대칭 섭취가 여러 차례 보고되었다. 저자들은 일측 성대마비 환자와 정상인에서 발성시와 침묵시의 성대근육의 활동정도를 FDG의 섭취로 비교하여 보았다. 방법 : 11명의 일측 성대마비 환자와(원인:thyroidectomy=7, lung cancer=1, others=3) 12 명의 정상인을 대상으로 FDG-PET 을 시행하였다. 이들을 각각 두그룹으로 나누어 발성군은 FDG 주사후 20분간 책을 읽고 비발성군은 평소 검사와 같이 발성을 금하였다. 성대근육을 5부위로 나누어 SUV를 측정하였고 이를 위해 최근 시행한 CT와 융합 영상을 만들었다. 결과: 일측성대마비환자는 건측 갑상피열근에 높은 섭취를 보였으며 발성군은($SUV=5.88{\pm}2.65$) 비발성군에 비하여($SUV=2.30{\pm}0.39$) 유의하게 높은 섭취를 보였다. 정상군에서는 발성시 외윤상피열근에 대칭적인 FDG 섭취증가를 보였고 후위의 피열간근이 가장 높은 섭취($SUV=3.68{\pm}0.96$)를 보였다. 결론: 발성시 FDG-PET 검사를 하면 일측 성대마비환자와 정상인은 각각 서로 다른 후두근육에 FDG 섭취를 보였다. PET-CT 영상 융합을 사용하여 일측 성대마비 환자의 보상에 관여하는 후두근육의 비대칭적인 FDG섭취를 이해하는 것이 영상 판독에 도움을 줄 수 있을 것이다.

양측 성대마비 환자에 대한 $CO_2$레이저 피열연골 내측부분절제술 (Medial Partial Arytenoidectomy by $CO_2$laser for Bilateral Vocal Cord Paralysis)

  • 최홍식;최영준;이용훈;박헌이
    • 대한기관식도과학회지
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    • 제4권2호
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    • pp.219-224
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    • 1998
  • Bilateral vocal cord paralysis can result in severe airway compromise. Over the years a variety of arytenoidectomy procedures have bee described, and one or more of these have been the gold standard for many years. A widely accepted treatment is endoscopic laser total arytenoidectomy. However, vocal results are usually poor. Objective : To evaluate the effect of treatment of endoscopic laser medial partial arytenoidectorny for bilateral vocal cord paralysis Material and Methods : We performed endoscopic medial partial arytenoidceomy with $CO_2$laser for 3 patients with bilateral vocal cord paralysis. The $CO_2$laser is operated with a continuous 7-watt beam in superpulse mode. We compared degree of dyspnea and glottic area of pre-operation with those of post-operation for 3 patients. We analysed aerodynamic study pre-operatively and post-operatively for 1 patient. Results The symptom of dyspnea was improved markedly and the glottic area was widened from 34% to 50% compared with that of pre-operation. The voice quality was slightly decreased. Tracheotomy was not necessary for not-tracheotomized patient and decanulation was possible for tracheotomized patient post-operatively. Cunclusion: The endoscopic laser medial partial arytenoidectomy is a convient and effective method for opening the posterior glottic airway.

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편측성대마비환자에 대한 피열연골내전술 (Arytenoid Adduction as a Surgical Treatment for Hoarseness with Unilateral Vocal Cord Paralysis)

  • 김광문;김영호;홍원표;최홍식
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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    • pp.74-74
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    • 1993
  • 다양한 원인에 의하여 야기되는 편측성대마비에 의한 애성을 치료하기 위하여 현재 사용되고 있는 방법으로는 테프론이나 실리콘 등의 성대내 주입술, 갑상연골성형술 등이 있다. 그러나 성대부전이 너무 크거나, 양측성대의 위상차이가 심한 경우에는 상기 수술법으로는 만족스러운 결과를 얻기가 용이하지 않다. 이런 경우에 피열연골의 근돌기를 외과적으로 노출시킨 후 측전방으로 당겨줌으로써 성대의 내전을 유도할 수 있는 피열연골내전술(arytenoid adduction)로 음성개선을 도모할 수 있다. 최근 저자들은 애성을 주소로 영동세브란스병원 이비인후과로 내원하였던 편측성대마비 환자 3예에서 보다 만족할만한 음성개선의 결과를 도모하고자 피열연골내전술을 시행하여 좋은 결과를 얻었기에 보고하는 바이다.

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시야 확보가 어려운 성대 폴립 환자에서의 내시경적 절제술 1예 (Endoscopic Resection of a Vocal Cord Polyp in a Patient with Difficult Laryngeal Exposure)

  • 이상국;이세아;이승재;이승원
    • 대한후두음성언어의학회지
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    • 제27권2호
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    • pp.138-140
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    • 2016
  • Vocal cord polyps are generally removed using a direct laryngoscope and surgical microscope. In some case of laryngeal microsurgery, laryngeal exposure with surgical microscope is difficult because of severalfactors. We experienced a case of vocal polyp with difficult laryngeal exposure in a 56 year old male patient. The vocal cord polyp was removed successfully through endoscopic approach.

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편측성대마비에 대한 제 1형 갑상성형술과 피열연골내전술의 동시수술시 술전 및 술후 음성언어분석비교 (Analysis of Pre and Post-Operative Speech In Combined Operation of Type I Thyroplasty and Arytenoid Adduction for Unilateral Vocal Cord Palsy)

  • 최홍식;정유삼;김성국;김영호;김광문
    • 대한후두음성언어의학회지
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    • 제9권1호
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    • pp.66-70
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    • 1998
  • Background and Objectives : The managements of unilateral vocal cord palsy include type Ⅰ thyroplasty and arytenoid adduction. One type operation has been shown no satisfactory effect. We evaluated preoperative and postoperative speech of unilateral vocal cord palsy patients who received combined operation of type Ⅰ thyroplasty and arytenoid adduction to help for the management plan of unilateral vocal cord palsy patients. Materials and Methods : We reviewed the postoperative results and complication of 17 surgically treated patients of unilateral vocal cord palsy at Severance hospital from Nov. 1996 to Dec. 1997 retrospectively. They were received combined operation of type Ⅰ thyroplasty and arytenoid adduction. Their pre and post-operative speech were analyzed with MDVP(Multi-Dimension-Voice analysis Program) of CSL(Computerized Speech Lab). Results : After the operation, MPT(Maximal Phonation Time) was increased and MFR(Mean Flow Rate) was decreased in all patients. NHR(Noise to Harmonic Ratio) and VTI(Voice Turbulence Index) were decreased : liner, RAP(Relative Average Perturbation Quotient), PPQ(Pitch Period Perturbation Quotient), sPPQ(smoothed Pitch Period Perturbation Quotient), vFo(fundamental frequency Variation) were decreased : Shimmer, APQ(Amplitude Perturbation Quotient), sAPQ(Smoothed Amplitude Perturbation Qoutient), vAm(Peak Amplitude Variation) were decreased in all the patients. Conclusions : In unilateral vocal cord pals), combined operation of type Ⅰ thyroplasty and arytenoid adduction could obtain satisfactory postoperative voice. MDVP has many parameters and good method for evaluation of voice surgery.

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각종 후두질환에서 음성치료의 효과 (The Efficiency of Voice Therapy on Various Laryngeal Disorders)

  • 왕수건;권순복;노환중;고의경;전경명
    • 대한후두음성언어의학회지
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    • 제10권1호
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    • pp.17-23
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    • 1999
  • Vocal hyperfunction is considered to be the most significant characteristic in larynx disorders which is found among many patients presenting hoarseness Primarily as chief complaint. In Pusan National University Hospital, we executed the voice therapy to 28 patients being 17 female and 11 male patients who visited the Voice & Speech Therapy Clinic, due to the voice disorder, and then compared and analysed the voice before and after its therapy using acoustic and aerodynamic test. The obtained results were as follows. In the analysis by the local findings, it was improved to 88% in the patients of vocal nodule, 75% in mutational falsetto, 75% in the functional dysphonia, 75% in the vocal cord palsy, 50% in the vocal polyp and 50% in dysphonia plica ventricularis. For the acoustic analysis, Fo, litter, Shimmer and NHR were measured. In the patients of mutational falsetto, Fo, Jitter and NHR were shown to be improved significantly and in the patients of vocal nodule, Shimmer was shown to be improved significantly. In the patients of vocal polyp, Fo was significantly improved. In the patients of vocal cord palsy in litter and NHH were significantly improved. In the patients of dysphonia plica ventricularis, Shimmer and NHR were significantly improved and the patients of functional dysphonia were more improved in Fo, litter and Shimmer. For the aerodynamic analysis, MPT was measured. In particular, it was shown to be improved significantly in the patients of vocal nodule, improved in the vocal polyp, vocal cord palsy, functional dysphonia patients.

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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.

A case of vocal cord gnathostomiasis diagnosed with sectional morphologies in a histopathological specimen from a Chinese woman living in Korea

  • Doo Sik Park;Eun Hyun Cho;Kyung Hoon Park;Soo Min Jo;Bumjung Park;Sun Huh
    • Parasites, Hosts and Diseases
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    • 제61권3호
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    • pp.298-303
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    • 2023
  • This study aimed to describe a rare case of gnathostomiasis in the vocal cord. A 54-yearold Chinese woman living in Korea visited with a chief complaint of voice change at the outpatient department of otorhinolaryngology in Hallym Sacred Heart Hospital, Hallym University on August 2, 2021. She had eaten raw conger a few weeks before the voice change developed, but her medical history and physical examinations demonstrated neither gastrointestinal symptoms nor other health problems. A round and red cystic lesion, recognized in the anterior part of the right vocal cord, was removed using forceps and scissors through laryngeal microsurgery. The histopathological specimen of the cyst revealed 3 cross-sections of a nematode larva in the lumen of the cyst wall composed of inflammatory cells and fibrotic tissues. They differ in diameter, from 190 ㎛ to 235 ㎛. They showed characteristic cuticular layers with tegumental spines, somatic muscle layers, and gastrointestinal tracts such as the esophagus and intestine. Notably, intestinal sections consisted of 27-28 lining cells containing 0-4 nuclei per cell. We tentatively identified the nematode larva recovered from the vocal cord cystic lesion as the thirdstage larva of Gnathostoma, probably G. nipponicum or G. hispidum, based on the sectional morphologies.