Naoko Ogata, R. Ueha, Taku Sato, T. Goto, A. Yamauchi, T. Yamasoba
Endotracheal intubation can induce various laryngeal injuries. Treatments for such injuries differ depending on the injured site and duration elapsed after intubation. We herein report two cases of laryngeal injury due to endotracheal intubation that required surgical treatment. Case 1 was an 80-year-old woman who suffered from dyspnea 2 days after surgery for lung cancer. She had been intubated with a thick, double-lumen endotracheal tube, and had exhibited persistent hoarseness since the surgery. Upon laryngeal endoscopy, her airway had almost completely closed due to membranous granulation covering the subglottis. Tracheostomy, removal of the granulation tissue, and local injection of triamcinolone acetonide were performed to secure the airway. Although several rounds of granulation tissue removal were required to achieve a safe airway, the tracheostoma was ultimately successfully closed. Case 2 was a 55-year-old man who had been intubated for 11 days after surgery for esophageal cancer. Hoarseness was evident immediately after extubation. Laryngeal endoscopy confirmed bilateral vocal fold paralysis at the paramedian position, but the airway was narrowly maintained. During follow-up, vocal fold mobility gradually improved for a time. However, bridge-like granulation appeared in the posterior glottis later, and vocal fold abduction gradually became impaired bilaterally. Removal of the granulation tissue and topical triamcinolone acetonide injection were performed to prevent scar formation. After the surgery, the vocal fold mobility fully recovered without recurrence of granulation tissue. Laryngeal injuries should be suspected when hoarseness is apparent after extubation, and surgical treatment should be considered in cases involving airway problems.
{"title":"Two Cases of Laryngeal Injury Due to Endotracheal Intubation that Required Surgical Treatment","authors":"Naoko Ogata, R. Ueha, Taku Sato, T. Goto, A. Yamauchi, T. Yamasoba","doi":"10.5426/LARYNX.32.207","DOIUrl":"https://doi.org/10.5426/LARYNX.32.207","url":null,"abstract":"Endotracheal intubation can induce various laryngeal injuries. Treatments for such injuries differ depending on the injured site and duration elapsed after intubation. We herein report two cases of laryngeal injury due to endotracheal intubation that required surgical treatment. Case 1 was an 80-year-old woman who suffered from dyspnea 2 days after surgery for lung cancer. She had been intubated with a thick, double-lumen endotracheal tube, and had exhibited persistent hoarseness since the surgery. Upon laryngeal endoscopy, her airway had almost completely closed due to membranous granulation covering the subglottis. Tracheostomy, removal of the granulation tissue, and local injection of triamcinolone acetonide were performed to secure the airway. Although several rounds of granulation tissue removal were required to achieve a safe airway, the tracheostoma was ultimately successfully closed. Case 2 was a 55-year-old man who had been intubated for 11 days after surgery for esophageal cancer. Hoarseness was evident immediately after extubation. Laryngeal endoscopy confirmed bilateral vocal fold paralysis at the paramedian position, but the airway was narrowly maintained. During follow-up, vocal fold mobility gradually improved for a time. However, bridge-like granulation appeared in the posterior glottis later, and vocal fold abduction gradually became impaired bilaterally. Removal of the granulation tissue and topical triamcinolone acetonide injection were performed to prevent scar formation. After the surgery, the vocal fold mobility fully recovered without recurrence of granulation tissue. Laryngeal injuries should be suspected when hoarseness is apparent after extubation, and surgical treatment should be considered in cases involving airway problems.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"452 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124092005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shinsuke Suzuki, Satoshi Toyoma, Yohei Kawasaki, K. Koizumi, Takechiyo Yamada
Tracheoesophageal shunt utterance using a voice prosthesis as a substitute voice after laryngectomy is an excellent method and is widely used. However, in addition to temporary removal due to complications, the use of voice prostheses is occasionally discontinued for various reasons that lead to their permanent removal. We evaluated the voice acquisition rate, complications, and outcomes of 23 patients who underwent voice reconstruction using a voice prosthesis after total laryngectomy in our department from January 2007 to December 2018 . The voice acquisition rate was 87 %. Seven complications occurred in six cases, the most common of which was granulation, followed by leakage and infection in one case each, although all were eventually rescued. However, there were five cases where permanent voice prosthesis removal was necessary for reasons other than complications. Three of these patients had good voice acquisition but were unable to use the voice prosthesis due to the effects of other diseases. In the other two cases, a voice could not be obtained, and the patients expressed their desire to have the prosthesis removed. In the future, aging of voice prosthesis users and long-term use are expected, which will make it necessary not only to accurately determine the adaptation in consideration of the patient’s intention, activity and living environment but also to consider how to proceed when voice prosthesis use becomes difficult due to other diseases.
{"title":"Clinical Outcomes for Patients with Voice Prosthesis","authors":"Shinsuke Suzuki, Satoshi Toyoma, Yohei Kawasaki, K. Koizumi, Takechiyo Yamada","doi":"10.5426/LARYNX.32.172","DOIUrl":"https://doi.org/10.5426/LARYNX.32.172","url":null,"abstract":"Tracheoesophageal shunt utterance using a voice prosthesis as a substitute voice after laryngectomy is an excellent method and is widely used. However, in addition to temporary removal due to complications, the use of voice prostheses is occasionally discontinued for various reasons that lead to their permanent removal. We evaluated the voice acquisition rate, complications, and outcomes of 23 patients who underwent voice reconstruction using a voice prosthesis after total laryngectomy in our department from January 2007 to December 2018 . The voice acquisition rate was 87 %. Seven complications occurred in six cases, the most common of which was granulation, followed by leakage and infection in one case each, although all were eventually rescued. However, there were five cases where permanent voice prosthesis removal was necessary for reasons other than complications. Three of these patients had good voice acquisition but were unable to use the voice prosthesis due to the effects of other diseases. In the other two cases, a voice could not be obtained, and the patients expressed their desire to have the prosthesis removed. In the future, aging of voice prosthesis users and long-term use are expected, which will make it necessary not only to accurately determine the adaptation in consideration of the patient’s intention, activity and living environment but also to consider how to proceed when voice prosthesis use becomes difficult due to other diseases.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"162 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132824561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yukari Tsuna, A. Inoue, K. Matsushima, Sachiko Hosono, K. Wada
Nasogastric tube syndrome (NGTS) is a rare syndrome that causes abduction dysfunction in both vocal folds after gastric tube insertion, and the clinical condition is poorly understood. We herein report a case of NGTS treated with larynx electromyography. An 89-year-old woman suddenly presented with stridor and dysphagia during medical treatment for ileus. Although the patient had a history of left vocal fold palsy of the paramedian position after aortic surgery, the right vocal fold was located medially and slightly dysfunctional, and the bilateral arytenoid regions were swollen on flexible larynx endoscopy. Because of the high glottic stenosis, emergency tracheostomy was performed. Two days later, the right vocal fold began to gradually move, and this motion improved substantially one week later. Therefore, she was diag-nosed with NGTS. Larynx electromyography reduced the interference pattern in the right thyroarytenoid mus-cle. Neuroparalysis was also suggested as a pathosis of NGTS.
{"title":"A Case Report: A Patient of Nasogastric Tube Syndrome Presenting with Vocal Fold Paresis","authors":"Yukari Tsuna, A. Inoue, K. Matsushima, Sachiko Hosono, K. Wada","doi":"10.5426/LARYNX.32.213","DOIUrl":"https://doi.org/10.5426/LARYNX.32.213","url":null,"abstract":"Nasogastric tube syndrome (NGTS) is a rare syndrome that causes abduction dysfunction in both vocal folds after gastric tube insertion, and the clinical condition is poorly understood. We herein report a case of NGTS treated with larynx electromyography. An 89-year-old woman suddenly presented with stridor and dysphagia during medical treatment for ileus. Although the patient had a history of left vocal fold palsy of the paramedian position after aortic surgery, the right vocal fold was located medially and slightly dysfunctional, and the bilateral arytenoid regions were swollen on flexible larynx endoscopy. Because of the high glottic stenosis, emergency tracheostomy was performed. Two days later, the right vocal fold began to gradually move, and this motion improved substantially one week later. Therefore, she was diag-nosed with NGTS. Larynx electromyography reduced the interference pattern in the right thyroarytenoid mus-cle. Neuroparalysis was also suggested as a pathosis of NGTS.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114188585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Miyamoto, I. Watanabe, A. Mogi, H. Nakagawa, Koichiro Saito
Computed tomography is useful for diagnosing laryngeal trauma, the extension of laryngeal cancer and lymph node metastasis of carcinoma. Yumoto et al. reported that helical CT was useful for evaluating three-dimensional images of the laryngeal structure. Furthermore, they performed helical CT in patients with unilateral vocal fold paralysis in order to understand the laryngeal morphology. Hiramatsu et al. reported that this approach visualized the movement of the arytenoid cartilages on reconstruction imaging. The present study evaluated six patients with unilateral vocal fold paralysis whose voices improved after phonosurgery. Two patients underwent arytenoid adduction and thyroplasty typeI, two underwent only thyroplasty typeI, and two underwent injection surgery. The virtual endoscopic images reconstructed from ultrahigh-resolution CT (UHRCT) showed a gap in the posterior glottal region in the cases for whom preoperative evaluations using flexible laryngoscopy had been very difficult due to supraglottic hypertension. Postoperative changes in the arytenoid position were observed on three-dimensional images. UHRCT was shown to be effective for selecting the phonosurgery approach. This modality is a very important tool for determining which phonosurgical procedures to perform and for evaluating the postoperative change. We successfully evaluated the anatomical changes, glottal closure and position of arytenoid cartilages preand postoperatively using UHRCT.
{"title":"Pre- and Postoperative Evaluations of Patients with Unilateral Vocal Fold Paralysis Using Ultra-high-resolution Computed Tomography","authors":"M. Miyamoto, I. Watanabe, A. Mogi, H. Nakagawa, Koichiro Saito","doi":"10.5426/LARYNX.32.178","DOIUrl":"https://doi.org/10.5426/LARYNX.32.178","url":null,"abstract":"Computed tomography is useful for diagnosing laryngeal trauma, the extension of laryngeal cancer and lymph node metastasis of carcinoma. Yumoto et al. reported that helical CT was useful for evaluating three-dimensional images of the laryngeal structure. Furthermore, they performed helical CT in patients with unilateral vocal fold paralysis in order to understand the laryngeal morphology. Hiramatsu et al. reported that this approach visualized the movement of the arytenoid cartilages on reconstruction imaging. The present study evaluated six patients with unilateral vocal fold paralysis whose voices improved after phonosurgery. Two patients underwent arytenoid adduction and thyroplasty typeI, two underwent only thyroplasty typeI, and two underwent injection surgery. The virtual endoscopic images reconstructed from ultrahigh-resolution CT (UHRCT) showed a gap in the posterior glottal region in the cases for whom preoperative evaluations using flexible laryngoscopy had been very difficult due to supraglottic hypertension. Postoperative changes in the arytenoid position were observed on three-dimensional images. UHRCT was shown to be effective for selecting the phonosurgery approach. This modality is a very important tool for determining which phonosurgical procedures to perform and for evaluating the postoperative change. We successfully evaluated the anatomical changes, glottal closure and position of arytenoid cartilages preand postoperatively using UHRCT.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130928235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Medialization procedures, such as type I thyroplasty, arytenoid adduction, and vocal fold injection, are currently popular treatments for hoarseness due to unilateral vocal fold paralysis. However, hoarseness occasionally remains after medialization procedures due to tension imbalance. This tension imbalance causes diplophonia, asymmetry and aperiodic vibrational flutter in travelling wave motion. This is mostly due to incomplete glottic closure, imbalance in muscular tension, and increased air flow through an incompetent glottis. There is no established treatment for tension imbalance. We herein report two cases with remaining hoarseness post-medialization for chronic unilateral vocal fold paralysis. These patients underwent voice therapy using flow phonation to establish respiratory support and a resonant voice to facilitate vocal fold vibration. As a result, the functional vocal fold vibration, aerodynamic assessments, acoustic analysis findings and self-rated condition improved in both cases after therapy. These results suggest that voice therapy involving flow phonation and resonant voice may help improve the vocal function in cases of tension imbalance with dysphonia. Further studies with a larger number of participants or a prospective randomized controlled trial are warranted.
{"title":"Efficacy of Voice Therapy for Remaining Hoarseness Due to Tension Imbalance Following Medialization Procedures","authors":"M. Kaneko, Y. Sugiyama, S. Hirano","doi":"10.5426/larynx.32.52","DOIUrl":"https://doi.org/10.5426/larynx.32.52","url":null,"abstract":"Medialization procedures, such as type I thyroplasty, arytenoid adduction, and vocal fold injection, are currently popular treatments for hoarseness due to unilateral vocal fold paralysis. However, hoarseness occasionally remains after medialization procedures due to tension imbalance. This tension imbalance causes diplophonia, asymmetry and aperiodic vibrational flutter in travelling wave motion. This is mostly due to incomplete glottic closure, imbalance in muscular tension, and increased air flow through an incompetent glottis. There is no established treatment for tension imbalance. We herein report two cases with remaining hoarseness post-medialization for chronic unilateral vocal fold paralysis. These patients underwent voice therapy using flow phonation to establish respiratory support and a resonant voice to facilitate vocal fold vibration. As a result, the functional vocal fold vibration, aerodynamic assessments, acoustic analysis findings and self-rated condition improved in both cases after therapy. These results suggest that voice therapy involving flow phonation and resonant voice may help improve the vocal function in cases of tension imbalance with dysphonia. Further studies with a larger number of participants or a prospective randomized controlled trial are warranted.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130962190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Suzuki, M. Higashino, Masataka Taniuchi, N. Suzuki, R. Kawata
{"title":"A Case of Masticatory Muscle Tendon Aponeurosis Hyperplasia with Severe Opening Disorder at Laryngeal Microsurgery","authors":"E. Suzuki, M. Higashino, Masataka Taniuchi, N. Suzuki, R. Kawata","doi":"10.5426/larynx.32.58","DOIUrl":"https://doi.org/10.5426/larynx.32.58","url":null,"abstract":"","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127085138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Takeshi Suzuki, Y. Seki, T. Matsumura, D. Sakurai, T. Hanazawa, Y. Okamoto, T. Hoppo
Objective: To assess the efficacy of laparoscopic anti-reflux surgery (LARS) for treating Japanese patients with laryngopharyngeal reflux disease (LPRD) refractory to proton pump inhibitor (PPI) therapy. Methods: The outcomes of LARS were retrospectively assessed using validated questionnaires, such as the reflux symptom index (RSI), in Japanese LPRD patients with abnormal proximal exposure (APE) as measured by hypopharyngeal multichannel intraluminal impedance-pH (HMII). Results: Twenty-eight patients with LPR symptoms and documented APE underwent LARS. Of these patients, 26 ( 93 %) saw significant symptomatic improvement, and their RSI values significantly improved postoperatively (19.8 ± 10.8 vs. 7.3 ± 8.1, p < 0.001). A mild retrosternal food-sticking sensation was reported in 5 patients (18%) postoperatively. Conclusion: LARS is an effective treatment for patients with LPR symptoms and documented APE as measured by HMII. HMII is essential for the evaluation of patients with LPR symptoms.
目的:评价腹腔镜抗反流手术(LARS)治疗日本质子泵抑制剂(PPI)治疗难治性喉咽反流病(LPRD)的疗效。方法:对日本LPRD近端异常暴露(APE)患者采用下咽多通道腔内阻抗- ph (HMII)测量的反流症状指数(RSI)等有效问卷对LARS的结果进行回顾性评估。结果:28例有LPR症状并有APE记录的患者行LARS治疗。其中26例(93%)患者症状明显改善，术后RSI值显著改善(19.8±10.8 vs. 7.3±8.1,p < 0.001)。5例(18%)患者术后出现轻微的胸骨后食物粘连感。结论:LARS是治疗LPR症状和HMII记录的APE患者的有效方法。HMII对LPR症状患者的评估至关重要。
{"title":"The Outcome of Anti-reflux Surgery for Patients with Laryngopharyngeal Reflux Disease","authors":"Takeshi Suzuki, Y. Seki, T. Matsumura, D. Sakurai, T. Hanazawa, Y. Okamoto, T. Hoppo","doi":"10.5426/larynx.32.29","DOIUrl":"https://doi.org/10.5426/larynx.32.29","url":null,"abstract":"Objective: To assess the efficacy of laparoscopic anti-reflux surgery (LARS) for treating Japanese patients with laryngopharyngeal reflux disease (LPRD) refractory to proton pump inhibitor (PPI) therapy. Methods: The outcomes of LARS were retrospectively assessed using validated questionnaires, such as the reflux symptom index (RSI), in Japanese LPRD patients with abnormal proximal exposure (APE) as measured by hypopharyngeal multichannel intraluminal impedance-pH (HMII). Results: Twenty-eight patients with LPR symptoms and documented APE underwent LARS. Of these patients, 26 ( 93 %) saw significant symptomatic improvement, and their RSI values significantly improved postoperatively (19.8 ± 10.8 vs. 7.3 ± 8.1, p < 0.001). A mild retrosternal food-sticking sensation was reported in 5 patients (18%) postoperatively. Conclusion: LARS is an effective treatment for patients with LPR symptoms and documented APE as measured by HMII. HMII is essential for the evaluation of patients with LPR symptoms.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132498441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Improving the pharyngeal stage of swallowing while preserving the laryngeal function is usually the most important goal of surgical treatment for the patients with severe dysphagia. To date, many surgical procedures have been introduced to allow patients to resume oral intake and thereby improve the patient’s quality of life. Typical surgical procedures include cricopharyngeal myotomy, laryngeal suspension, type I thyroplasty, aryte-noid adduction, injection laryngoplasty, and pharyngeal flap surgery, etc. Considering the increasing number of patients with dysphagia in an aging society in recent years, otolaryngologists should therefore be knowledgea-ble of as many surgical procedures as possible. However, since surgery is not indicated for all patients with pharyngeal stage dysphagia, the pathological conditions of dysphagia should be properly understood based on the patient’s physical, mental and social backgrounds. According to each surgical principle and indication, it is necessary to perform one or more appropriate surgical procedures.
{"title":"Surgery for Improving Function of Swallowing","authors":"S. Chitose","doi":"10.5426/larynx.32.8","DOIUrl":"https://doi.org/10.5426/larynx.32.8","url":null,"abstract":"Improving the pharyngeal stage of swallowing while preserving the laryngeal function is usually the most important goal of surgical treatment for the patients with severe dysphagia. To date, many surgical procedures have been introduced to allow patients to resume oral intake and thereby improve the patient’s quality of life. Typical surgical procedures include cricopharyngeal myotomy, laryngeal suspension, type I thyroplasty, aryte-noid adduction, injection laryngoplasty, and pharyngeal flap surgery, etc. Considering the increasing number of patients with dysphagia in an aging society in recent years, otolaryngologists should therefore be knowledgea-ble of as many surgical procedures as possible. However, since surgery is not indicated for all patients with pharyngeal stage dysphagia, the pathological conditions of dysphagia should be properly understood based on the patient’s physical, mental and social backgrounds. According to each surgical principle and indication, it is necessary to perform one or more appropriate surgical procedures.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"107 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116065801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In a super-aging society, dysphagia has become a major problem. Dysphagia is caused by primary diseases, such as cerebrovascular diseases and neurodegenerative diseases, as well as head and neck tumors. In addition, disuse muscle atrophy and sarcopenia may cause swallowing disturbances. Rehabilitation is an important treatment for dysphagia. However, rehabilitation deals with disorders, thus, it needs to performed comprehensively in context with the patient’s ability, activity, and environment. In consideration of the general condition, safe oral intake needs to be ensured via prevention of aspiration by respiratory rehabilitation combined with risk management. Attempts have been made to objectively evaluate and provide feedback on the intensity, amount, and effect of rehabilitation. Several treatment methods, including neurorehabilitation, have been established. However, limited information is available about evidence-based treatment for rehabilitation. As per the current recommendations, rehabilitation should be performed according to the type of dysphagia. To date, reports veri-fying the effectiveness of training have been scant, and further research on this subject is warranted.
{"title":"Rehabilitation for Dysphagia","authors":"F. Oshima, Masako Fujiu-kurachi, I. Fujishima","doi":"10.5426/larynx.32.20","DOIUrl":"https://doi.org/10.5426/larynx.32.20","url":null,"abstract":"In a super-aging society, dysphagia has become a major problem. Dysphagia is caused by primary diseases, such as cerebrovascular diseases and neurodegenerative diseases, as well as head and neck tumors. In addition, disuse muscle atrophy and sarcopenia may cause swallowing disturbances. Rehabilitation is an important treatment for dysphagia. However, rehabilitation deals with disorders, thus, it needs to performed comprehensively in context with the patient’s ability, activity, and environment. In consideration of the general condition, safe oral intake needs to be ensured via prevention of aspiration by respiratory rehabilitation combined with risk management. Attempts have been made to objectively evaluate and provide feedback on the intensity, amount, and effect of rehabilitation. Several treatment methods, including neurorehabilitation, have been established. However, limited information is available about evidence-based treatment for rehabilitation. As per the current recommendations, rehabilitation should be performed according to the type of dysphagia. To date, reports veri-fying the effectiveness of training have been scant, and further research on this subject is warranted.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124884106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Masanobu Mizuta, K. Iwanaga, A. Yoshizawa, M. Nonomura, Shinichi Sato
Laryngeal chondrosarcoma is a rare tumor, accounting for 0 . 2 % of all malignant laryngeal tumors. Since grade 1 laryngeal chondrosarcoma is associated with a good prognosis, larynx-preserving surgery is desirable. This report describes a case of cricoid chondrosarcoma in which a cricoid cartilage defect was reconstructed with muscle-pedicled thyroid cartilage after tumor resection. A 62-year old man was referred to our hospital due to a subglottal tumor that was incidentally detected on cervical spine MRI. CT images revealed a tumor that had developed from the cricoid cartilage, and the diagnosis of chondrosarcoma, grade 1 was confirmed based on the findings of a histological examination. The patient underwent partial cricoidectomy with reconstruction using muscle-pedicled thyroid cartilage. Although tracheostomy was performed intraoperatively, he was decannulated 2 months later. At 1 year after surgery, the patient is currently alive with no evidence of recurrence and normal oral feeding.
{"title":"Laryngeal Reconstruction with Pedicled Thyroid Cartilage for Cricoid Chondrosarcoma","authors":"Masanobu Mizuta, K. Iwanaga, A. Yoshizawa, M. Nonomura, Shinichi Sato","doi":"10.5426/larynx.32.67","DOIUrl":"https://doi.org/10.5426/larynx.32.67","url":null,"abstract":"Laryngeal chondrosarcoma is a rare tumor, accounting for 0 . 2 % of all malignant laryngeal tumors. Since grade 1 laryngeal chondrosarcoma is associated with a good prognosis, larynx-preserving surgery is desirable. This report describes a case of cricoid chondrosarcoma in which a cricoid cartilage defect was reconstructed with muscle-pedicled thyroid cartilage after tumor resection. A 62-year old man was referred to our hospital due to a subglottal tumor that was incidentally detected on cervical spine MRI. CT images revealed a tumor that had developed from the cricoid cartilage, and the diagnosis of chondrosarcoma, grade 1 was confirmed based on the findings of a histological examination. The patient underwent partial cricoidectomy with reconstruction using muscle-pedicled thyroid cartilage. Although tracheostomy was performed intraoperatively, he was decannulated 2 months later. At 1 year after surgery, the patient is currently alive with no evidence of recurrence and normal oral feeding.","PeriodicalId":338069,"journal":{"name":"Koutou (THE LARYNX JAPAN)","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134148130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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