성대주입술 후 발생한 성대 내 농양 1례

이종숙,김지원,최승호,Yi, Jong-Sook,Kim, Ji-Won,Choi, Seung-Ho 대한후두음성언어의학회 2010 대한후두음성언어의학회지 Vol.21 No.2

Unilateral vocal cord paralysis occurs from a dysfunction of the recurrent laryngeal nerve. It causes a characteristic hoarseness, shortness of breath and swallowing disability. Prompt injection laryngoplasty is a treatment options that aims to improve these symptoms less invasively and easily than any other procedures. Cross-linked hyaluronic acid (HA) is widely used injection material. It is non-mammalian polysaccharides derived from streptococcus strain and well known for its duration in vocal cord about 3-6 months after injection. However, there were no complication reports such as infection or rejection after HA injection laryngoplasty in previous report. We present a case of patient with laryngeal abscess after transcricothyroid membrane percutaneous HA injection laryngoplasty.

흡인을 동반한 일측성 성대마비 환자에서 일시적 성대주입술의 역할

장현,안영진,임윤성,하정훈,성명훈,김광현,권택균 대한이비인후과학회 2009 대한이비인후과학회지 두경부외과학 Vol.52 No.3

Background and Objectives:We evaluated the role of temporary injection laryngoplasty in patients with unilateral vocal fold paralysis (UVFP) after cardiothoracic surgeries. Subjects and Method:Taking the introduction of injection laryngoplasty as a milestone, we divided patients into those who underwent cardiothoracic surgery with UVFP during the years 2001-2004, before the introduction of injection laryngoplasty as pre-injection group (n=83) and those who underwent after the introduction during the years 2000-2007 as post-injection group (n=103). Of the post injection group, patients who received injection laryngoplasty postoperatively before being discharged were defined as injection group (n=37). Patients were also divided into non-esophageal surgery group and esophageal surgery group. Clinical outcomes including the length of hospital stay and oral feeding initiation time were compared between the pre-injection group and the injection group within the same operation group. The degrees of aspiration were classified into 4 grades. Results:In the non-esophageal surgery group, the injection group with aspiration grade III had shorter hospital stay and oral feeding initiation time after extubation compared to the pre-injection group with grade III aspiration (p=0.042). However, in the esophageal surgery group, there was no statistical difference between the pre-injection and injection groups. Conclusion:Temporary injection laryngoplasty can reduce the hospital stay and enhance oral feeding initiation in patients with aspiration due to UVFP after non-esophageal cardiothoracic surgeries.

성대주입물질의 최신지견

이승원,김재욱 대한이비인후과학회 부산,울산,경남 지부회 2010 임상이비인후과 Vol.21 No.2

성대주입술

선동일,Sun, Dong-Il 대한후두음성언어의학회 2013 대한후두음성언어의학회지 Vol.24 No.2

In recent years, the application of injection laryngoplasty to a variety of laryngeal disorders has regained popularity. The technique of injection laryngoplasty has several appealing qualities including relative technical ease, low cost, and wide availability in many clinical settings. A growing number of injectable substances and injection methods have been developed. This review is intended to provide an updated discussion of indications, materials, and techniques for injection laryngoplasty.

외래에서 시행하는 경윤상갑상막 접근 성대주입술 중 주입 위치를 정확하게 파악하는 방법에 관한 기술적 고찰

박성준,권택균 대한후두음성언어의학회 2018 대한후두음성언어의학회지 Vol.29 No.2

The office-based, un-sedated vocal fold injection laryngoplasty has re-emerged in the past decade as an appealing alternative to microsuspension laryngoscopic procedure which is conducted under general anesthesia. The trend toward vocal fold injection laryngoplasty in an in-office setting was possible due to technological evolution for visualization and new injection materials. However, invisibility of the injection needle has been the main shortcomings of cricothyroid approach. The purpose of this review is to provide an up-to-date review of office-based, trans-cricothyroid membrane approach injection laryngoplasty technique under local anesthesia and efforts made to increase the preciseness of amount and location of the injected materials in the management of glottic insufficiency. A review of variable efforts undertaken to maximize the result of cricothyroid approach by technically increasing accuracy of the location of needle tip was done. With the proper patient selection and utilization of the new technologies, office-based and un-sedated vocal fold injection laryngoplasty via cricothyroid approach can be redeem as a main-stay in the management of glottic insufficiency, such as vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar.

일측 성대마비 환자에서 Calcium-Hydroxyapatite를 이용한 성대 주입술의 유용성

이재훈,김성원,오정호,김승태,이강대,Lee, Jae-Hoon,Kim, Sung-Won,Oh, Jung-Ho,Kim, Seung-Tae,Lee, Kang-Dae 대한후두음성언어의학회 2011 대한후두음성언어의학회지 Vol.22 No.2

Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

성대주입술의 합병증

박영학,김주환,Park, Young-Hak,Kim, Joo-Hwan 대한후두음성언어의학회 2011 대한후두음성언어의학회지 Vol.22 No.1

Injection laryngoplasty is one of the most frequently performed procedures in patients with glottic insufficiency. Various materials and injection sites have been used to medialize the true vocal folds. Ideal material would be easily injected through a fine- gauge needle, well tolerated, long lasting and without complications. Although injection laryngoplasty rarely result in complication, physicians must be familiar with the types of complications that can occur. Proper diagnosis and prompt management of complication can result in good outcome.

성대주입술을 결합한 음성치료의 효과 연구

안철민,정화원,신정은,Ahn, Cheol Min,Jung, Hwa Won,Shin, Jung Eun 대한후두음성언어의학회 2017 대한후두음성언어의학회지 Vol.28 No.1

Background and Objectives : Though voice therapy is proven to be effective in academia, treatment results and satisfaction level are inconsistent in clinics. The inconsistency may rise from diverse vocal cords misuse patterns in patient population as they suffer from different diseases or have bad phonation habits. In order to overcome the limitation, we uniformized patients' vocal cords with injection laryngoplasty prior to voice therapy. The efficacy of voice therapy and consistency in treatment results after injection laryngoplasty were assessed. Materials and Methods : Patients diagnosed with vocal nodules were either treated with injection laryngoplasty followed by voice therapy (combined treatment group) or voice therapy only (voice therapy group). Each group consisted of 15 patients. Acoustic measures (jitter, shimmer, NHR), aerodynamic measures (MPT, Psub, MAFR), and subjective auditory conscious measures (K-VHI, K-VRQOL) between two groups were analyzed. Results : After treatments, both groups improved in terms of acoustic, aerodynamic, and subjective auditory conscious measures compared to pre-treatment. Combined treatment group had statistically significantly greater improvement in shimmer, P in K-VHI, and PF in K-VRQOL compared to voice therapy group. Conclusion : Injection laryngoplasty treatment prior to voice therapy synergizes in treating patients compared to voice therapy only.

경부 신전이 불가한 성대 마비 환자에서 I-Gel$^{TM}$ 후두마스크를 이용한 전신 마취하 성대주입술 증례

조광희,정찬민,장철호,최홍식,Jo, Kwang-Hee,Jung, Chan-Min,Jang, Chul-Ho,Choi, Hong-Shik 대한후두음성언어의학회 2014 대한후두음성언어의학회지 Vol.25 No.2

Injection laryngoplasty is simple and useful procedure in patient with vocal cord paralysis even under local anesthesia. For approaching vocal cord level, flexibility of neck mobility is required to operate injection laryngoplasty but it is relatively difficult to approach vocal cord in patient who has cervical fixations. Laryngeal mask airway (LMA) can be helpful:We use a LMA (I-gel$^{TM}$) during intubation without neck extension on flat supine position under general anesthesia and have a good operation filed. LMA with swivel connector give surgeons better surgical vision and make insertion of fibroscope easily during operation. Hyaluronic acid injection was done use needle (25 G, 5 cm) via percutaneous cricothyroid space : This procedure can be useful method for patients who suffer from not only weak voice but also dysphagia and aspiration high vagal palsy patient after spine surgery or uncooperative with awake injection laryngoplasty.

일측 성대마비 환자에 대해 음성치료와 성대주입술의 초기 치료 효과 비교 연구

이창윤,안수연,장현,손희영,Lee, Chang-Yoon,An, Soo-Youn,Chang, Hyun,Son, Hee Young 대한후두음성언어의학회 2017 대한후두음성언어의학회지 Vol.28 No.2

Background and Objectives : The purpose of this study was to classify patients with unilateral vocal fold paralysis according to their fixed location and to analysis the effects of two treatment methods by early voice therapy and injection laryngoplasty. Materials and Methods : Twenty patients who were classified as full abduction and slight abduction according to the position of paralysis were treated injection laryngoplasy, and 23 patients were treated by voice therapy. Twenty patients were treated injection laryngoplasy and 23 patients were treated voice therapy. Results were evaluated by acoustic analysis, electroglottography, cepstrum analysis before and after therapy. The voice therapy was conducted by improving the larynx movement and glottal contact, whilst removing hypertension of the supraglottic and use the breathing. Results : Significant improvement was found in the acoustic parameter, cepstrum parameter, and EGG before and after treatment in both groups. There was no significant difference between the two groups when compared before and after treatment to compare the effects of injection laryngoplasty and voice therapy. Conclusion : The initial treatments for unilateral vocal cord paralysis are injection laryngoplasty and voice therapy. however, there is no precise standard about which method should be applied first. Therefore, in this study, we tried to classify patients according to their paralysis position and then apply two methods. The results of this study suggest that voice therapy and Injection laryngoplasty at the initial stage is a very useful method to improve voice quality of vocal fold paralysis and improve laryngeal function.