상부위장관내시경 검사의 합병증으로 발생한 일측성 성대마비 2예 = Two Cases of Vocal Cord Paralysis Complicated by Upper Gastrointestinal Endoscopy

다국어 초록 (Multilingual Abstract)

Upper Gastrointestinal endoscopy is extensively used these days and its various complications, including cardiopulmonary disease, bleeding, perforation and infection, have been reported on, but vocal cord paralysis as a complication of endoscopy has not been reported on. The pressure on the larynx by the endoscopic tip itself or the gag reflex during endoscopy could cause vocal cord paralysis as the endoscopic tip passes through the pyriform sinus, which is close to the recurrent laryngeal nerve and arytenoid cartilage. We experienced two cases of vocal cord paralysis as complications of upper Gastrointestinal endoscopy and we report on them here. (Korean J Gastrointest Endosc 2006;33:32-36)

국문 초록 (Abstract)

상부소화관내시경 검사는 광범위하게 시행되고 있으며 심폐질환, 출혈, 천공 그리고 감염 등 다양한 합병증들이 보고되어 왔으나 성대마비에 대해서는 보고된 바 없다. 검사 시 내시경 선단은 이상와(pyriform sinus)를 통과하여 상부식도로 진입하게 된다. 이상와는 얇은 근육을 사이에 두고 반회후두신경(recurrent laryngeal nerve) 및 피열연골(arytenoid cartilage)과 접해 있는데 이들은 모두 성대마비의 주원인 기전으로 작용하는 구조물이다. 따라서 내시경 선단의 직접적인 압박이나, 선단이 이상와에 진입한 상태에서, 구역반사로 인해 후두에 대한 압박이 발생하면 반회후두신경의 마비나 피열연골의 부분탈구 등으로 성대마비가 야기될 수 있음을 유추할 수 있다. 저자는 상부위장관내시경 검사 직후 발성장애와 애성이 발생하여 후두경 등의 검사를 통해 일측성 성대마비를 진단하였던 2예를 경험하여 보고한다.

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