著者

宮本 真 楠山 敏行 森 有子 中川 秀樹 田村 悦代 新美 成二 福田 宏之

出版者

THE JAPAN LARYNGOLOGICAL ASSOCIATION

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.21, no.2, pp.117-122, 2009-12-01 (Released:2014-12-26)

参考文献数

5

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Vocal fold scarring due to injury, inflammation or surgery results in stiffness of the layer structure of the vocal fold. In addition, the mucosal waves are singnificantly affected, thereby resulting in severe dysphonia. Many therapeutic strategies have been attempted for the treatment of vocal fold scarring including voice therapy, steroid injection, injection laryngoplasty, tissue engineering and regenerative medicine. Our surgical method involves the removal of the vocal fold scarring under laryngomicrosurgery. From 2001 to 2007, we performed our phonosurgery technique on 18 patients with vocal fold scarring. The 15 patients whom were observed over two months (6 men and 9 women) ranged in age from 19 to 67 years (average age, 42.9 years). Our observations involved evaluation of subjective symptoms, as well as stroboscopic and phonometer examinations. The operation is performed under the general anesthesia. The approach is to resect the vocal fold nodule-like scarring and to resect vocal fold scarring under the mucosal epithelium. Twelve of the 18 patients had satisfactory post-surgery traveling waves and phonation. Definitive strategies in the treatment of vocal fold scarring have yet to be established. Our surgical method to treat scar formation is to remove the scar tissue under the mucosa. The key point is that we strive to attain the most excellent wound healing in order to achieve the closest reproduction of a normal vocal fold structure.

著者

楠山 敏行 池田 俊也 中川 秀樹 沢田 亜弓 木村 晋太

出版者

日本音声言語医学会

雑誌

音声言語医学 (ISSN:00302813)

巻号頁・発行日

vol.58, no.4, pp.333-338, 2017 (Released:2017-10-20)

参考文献数

20

被引用文献数

1

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音声障害を訴える歌唱者のなかで急性上気道炎症状を伴わない慢性上咽頭炎(以下上咽頭炎)が原因と思われる症例に対して1%塩化亜鉛による上咽頭処置(Bスポット療法)を行い,その治療効果を検討した.過去1年7ヵ月間にBスポット療法前後に内視鏡検査,音声検査,Voice Handicap Index-10(VHI-10)およびSinging Voice Handicap Index-10(SVHI-10)による評価が可能であった歌唱者53例を対象とした.内視鏡所見,VHI-10,SVHI-10,および最長発声持続時間における有意な改善を認めた.SVHI-10減少幅が5以上の症例は41例で78%の改善率であった.以上より上咽頭炎は音声障害の原因疾患の一つと考えられ,Bスポット療法は上咽頭炎による音声障害に対し有効であることが示唆された.また,その病態は自律神経系に関連する喉頭潤滑障害と上咽頭の共鳴障害であると考察した.