著者

眞田 友明 田中 信三 佐藤 公則 平野 実

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 補冊 (ISSN:09121870)

巻号頁・発行日

vol.1993, no.Supplement62, pp.27-32, 1993-06-15 (Released:2012-11-27)

参考文献数

10

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One hundred ninety eight patients with Reinke's edema who visited our clinic between 1981 and 1990 were retrospectively studied. One hundred twenty four were males and 74were females. Ninety percent of the patients were between 30 and 69 years old. Brinkman's index was 400 or more in 78% of patients. This suggests that smoking was the most important etiological factor. Surgery was performed for 73 cases and the hoarseness improved in 63 cases. Thirty one patients stopped smoking for more than a month without surgery, and 16 cases showed vocal improvement. Surgery was effective regardless of the size of the lesion, while prohibition of smoking was effective only for slight edema. Voice therapy without surgery or prohibition of smoking had no effect on hoarseness.

著者

田中 信三 窪田 清己 田辺 正博

出版者

The Japan Broncho-esophagological Society

雑誌

日本気管食道科学会会報 (ISSN:00290645)

巻号頁・発行日

vol.35, no.4, pp.287-292, 1984-08-10 (Released:2010-02-22)

参考文献数

9

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Living canine larynx was blown through the trachea with both arytenoid cartilages fixed in the median position. The sound pressure level and fundamental frequency of the voice were measured under various flow rates and subglottal pressures, with and without electric stimulation of the thyroarytenoid muscles. From this experiment, the role of the thyroarytenoid muscles in voice regulation was found to be as follows:1) When the glottis is sufficiently closed, contraction of the thyroarytenoid muscles does not affect the relationship between aerodynamic power (flow rate times pressure) and the sound pressure level, in spite of increased glottal resistance (pressure divided by flow rate).2) When the glottis is sufficiently closed, contraction of the thyroarytenoid muscles decreases the fundamental frequency in relatively large aerodynamic powers.

著者

田中 信三

出版者

耳鼻咽喉科臨床学会

雑誌

耳鼻咽喉科臨床 (ISSN:00326313)

巻号頁・発行日

vol.99, no.7, pp.513-518, 2006-07-01 (Released:2011-10-07)

参考文献数

19

被引用文献数

2

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Change and its significance in the treatment of the hypopharyngeal carcinoma (HPC) are discussed, chiefly based on the author's experiences. In the nineteen-seventies and eighties, the prognosis of HPC was poor, and the 5-year over-all survival was only 24% in 173 patients. Locoregional recurrence was the most serious problem. To improve locoregional control, we introduced extended surgery with reconstruction using a free jejunal graft, in which a safety margin of 3cm or more was secured at the primary site while bilateral retropharyngeal and paratracheal dissections were added to bilateral radical neck dissections. This treatment achieved a disease-specific 3-year survival of 64% for patients with advanced (stage III, IV) HPC, which was significantly better than that of patients treated by previous methods. Furthermore, postoperative radiotherapy was introduced for advanced HPC treatment, in which a 50Gy dose was basically used to irradiate the bilateral neck and a 10Gy dose was locally added when a retropharyngeal lymphnode metastasis was histopathologically identified or the number of lymphnode metastasis was three or more. In the recent five years, the disease-specific 3-year survival reached 81% in 39 advanced HPC patients. During this period, we endeavored to conserve in laryngeal functions for patients with early (stage I, II) HPC by performing a radiotherapy or partial pharyngectomy. In 14 early HPC patients, there was no recurrence and the larynx was well conserved in eleven. We also developed a new method of reconstruction after partial laryngopharyngectomy, in which aspiration was well prevented by reconsfructing the supraglottis and hypopharynx using hyoid bone attached to sternohyoid muscle and free forearm flap. Progress in surgical reconstruction techniques and radiotherapy changed the treatment of HPC, providing a better prognosis for advanced HPC patients and a better life quality for early HPC patients.