著者

川井田 政弘 福田 宏之 加納 滋 蓼原 東紅 大木 和明 凌 梅英 紀太 康一

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.38, no.3, pp.309-313, 1987-06-10 (Released:2010-02-22)

参考文献数

20

被引用文献数

1

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This is a report of a patient with sudden hoarseness which was probably caused by mis-inhalation of a commercially-available alkaline disinfectant. The patient was a 27-year-old female who sprayed it in a small room in order to prevent mould. She said she inhaled carelessly much amount of it. Next day, she suffered from hoarseness and strange sensation in her throat and visited our clinic.The laryngo-fiberscopical observation revealed that there were small masses with smooth suface at the posterior wall of the larynx bilaterally.The masses were resected under microlaryngoscopy and vaporized completely with a CO2 laser. A histopathological study revealed that the masses were nonspecific glanulomas.This disinfectant was one of strong alkalis chiefly consisting of NaOCl and NaOH. The corrosive action of the strong alkali might cause minute injuries around the bilateral vocal processes of the arytenoid cartilages. The granulomatous mass was probably produced by the injuries with secondarily occured bacterial infection.No recurrence has been found under the mirror-laryngoscopy after the treatment.

著者

長西 秀樹 森 有子 木村 美和子 中川 秀樹 田村 悦代 新美 成二 福田 宏之

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.53, no.2, pp.153-157, 2012 (Released:2012-06-11)

参考文献数

12

被引用文献数

1

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職業歌手にみられる急性炎症による音声障害へ対処する場合には,職業上の要請が強いため,通常の診察・治療に加えて,歌手特有の特殊性を考慮する必要がある.しかし,診療の進め方に特別なことがあるわけではなく問診に始まり声の評価,発声器官の所見に基づく治療を行う.声帯の状態を正確に把握することが重要であり,その評価のためには喉頭ストロボスコピーが有用である.当センターでは,薬物治療,外来でのネブライザー療法,音声治療を中心に治療方針を決定し,声帯の浮腫の状態に応じて,ステロイド投与の適応,その投与方法を決定している.東京ボイスセンターを2010年1年間に受診した急性炎症による音声障害症例は176名で,そのうち職業歌手は56名(31.8%)であった.職業歌手に対する急性期のステロイド投与方法としては,ステロイド吸入のみで対応した症例が最も多く,次いでステロイド点滴,ステロイド内服の順であった.

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

馬 燕 福田 宏之 牧野 克己 酒向 司 塩谷 彰浩 神崎 仁

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.43, no.4, pp.339-343, 1992-08-10 (Released:2010-06-11)

参考文献数

16

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The therapeutic method for laryngeal papilloma is still not definitely established. It is a general principle that the laryngeal papilloma should be surgically removed as much as possible. For the purpose, laser surgery has been used and therapeutic potency could be expected to some extent. However, since this disease is a high recurrence, especially in case of infant or child, it is easily induced to papillomatosis, resulting in the tracheal invasion.Here, in this paper a case of laryngeal papillomatosis is reported. The patient is 10 years old, and received frequent surgical operations without any success. For this case, medication with the traditional Chinese medicine has been performed, resulting in no recurrence.

著者

川崎 順久 福田 宏之 辻 ドミンゴス浩司 塩谷 彰浩 高山 悦代 川井田 政弘

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.41, no.3, pp.236-240, 1990

被引用文献数

1

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Recently CO2 laser surgery has been employed for Ti glottic cancer to avoid side effects caused by irradiation. However phonatory disturbance caused by post-operative anterior glottic web is sometime troublesome to patients. In this study, a survey of 17 patients with Ti glottic cancer, whose anterior comissure was vaporized with CO2 laser, was reviewed. In eight cases among them, anterior glottic web was observed during post operative course. Hence, we applied the fibrin glue (Tisseel) on the vaporized wound in 4 cases of Ti glottic cancer to avoid post-operative anterior glottic web. Post-operative wound healing of vocal folds were excellent in each cases. In the cases of anterior comissure involvement, the fibrin glue is applicable adjunct for prevention of anterior glottic web with CO2 laser surgery.

著者

川崎 順久 福田 宏之 辻 (ドミンゴス)浩司 酒向 司 塩谷 彰浩 馬 燕 川井田 政弘

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.43, no.1, pp.38-42, 1992

被引用文献数

1

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Neurinoma of the vocal fold is not common. A 43-year-old female with neurinoma of the left vocal fold was treated by microlaryngeal surgery. Clinical observation using laryngostrobovideography and CT revealed a smooth mass localized in the left vocal fold. The tumor was successfully removed under general anesthesia by microlaryngeal surgery. We applied the fibrin-glue (Tisseel®) on the surgical wound of the vocal fold to avoid post-operative scar. Postoperative wound healing of the vocal fold was excellent in this case. Her phonatory function was satisfactory and no tumor recurrence have been noted after surgery. In this case, the fibrin glue might have good effect on the wound healing of the vocal fold.

著者

川崎 順久 福田 宏之 酒向 司 塩谷 彰浩 辻 ドミンゴス 浩司 高山 悦代 蓼原 東紅

出版者

The Japan Society of Logopedics and Phoniatrics

雑誌

音声言語医学 (ISSN:00302813)

巻号頁・発行日

vol.31, no.4, pp.381-387, 1990

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小児声帯結節の治療方針について, 全国の耳鼻咽喉科医62名を対象にアンケート調査を行った.その結果, (1) 60名中55名が小児声帯結節は男児に多いと回答した. (2) 治療方針は保存的治療, 経過観察, 希望があれば手術を行う, の順に多かった. (3) 積極的に手術を施行しない理由として, 再発しやすいから, 自然治癒しやすいから, との回答が多かった. (4) 手術を行う場合, 96.9%が入院のうえ, 93.8%が挿管全身麻酔によるラリンゴマイクロサージェリーを施行すると回答した. (5) 以上の結果から, 小児声帯結節の治療方針として, まずは保存的治療あるいは経過観察を行うという意見が大半を占めたが, 音声外科を専門としない耳鼻咽喉科医の間では本疾患の自然治癒に関する認識は不十分であった.

著者

塩谷 彰浩 大久保 啓介 福田 宏之 小川 郁

出版者

The Japan Laryngological Association

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.14, no.2, pp.69-73, 2002

被引用文献数

1

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Juvenile laryngeal papillomatosis develops between the ages of 6 months and 4-5 years and runs a multiple and recurrent clinical course. There were 61 patients with laryngeal papillomatosis treated at Keio university hospital during the 20-year period between May 1981 and May 2001, of whom 20 patients were under the age of 15 at onset. The average number of repeated operations they received was 18.1, showing the pronounced multiple, recurrent trend of this disease. Treatment is basically laryngomicrosurgery using a CO<SUB>2</SUB> laser, and attempts should be made to conserve normal mucosa as much as is practicable as well as to improve phonation and respiratory function, in addition to targeting the total resection of the tumor. As the human papilloma virus, which is etiologically responsible for the formation of papillomas, grows in the mucosal epithelium, it is in principle, sufficient to vapolize the epithelial layer alone, avoiding a deeper intervention than is required. Tracheostomy should be avoided wherever feasible because it may cause tumor dissemination. Development of effective adjuvant therapy, besides surgery, is also generally anticipated. Efficacy of interferon-&alpha; in this disease has been demonstrated and indole 3 carbinol (I3C), a major component of cabbage, and the antiviral agent cidofovir are also currently used. Independently, we focused on Chinese medicines, prescribing this type of herbal medicines in anticipation of their effects for contraction of residual tumor and preventive effects against recurrence. It is worth noting that favorable results have been observed in 6 of the 10 patients receiving Chinese medicines whose therapeutic responses could be evaluated.

著者

塩谷 彰浩 大久保 啓介 福田 宏之 小川 郁

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.14, no.2, pp.69-73, 2002-12-01 (Released:2012-09-24)

参考文献数

16

被引用文献数

1 1

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Juvenile laryngeal papillomatosis develops between the ages of 6 months and 4-5 years and runs a multiple and recurrent clinical course. There were 61 patients with laryngeal papillomatosis treated at Keio university hospital during the 20-year period between May 1981 and May 2001, of whom 20 patients were under the age of 15 at onset. The average number of repeated operations they received was 18.1, showing the pronounced multiple, recurrent trend of this disease. Treatment is basically laryngomicrosurgery using a CO2 laser, and attempts should be made to conserve normal mucosa as much as is practicable as well as to improve phonation and respiratory function, in addition to targeting the total resection of the tumor. As the human papilloma virus, which is etiologically responsible for the formation of papillomas, grows in the mucosal epithelium, it is in principle, sufficient to vapolize the epithelial layer alone, avoiding a deeper intervention than is required. Tracheostomy should be avoided wherever feasible because it may cause tumor dissemination. Development of effective adjuvant therapy, besides surgery, is also generally anticipated. Efficacy of interferon-α in this disease has been demonstrated and indole 3 carbinol (I3C), a major component of cabbage, and the antiviral agent cidofovir are also currently used. Independently, we focused on Chinese medicines, prescribing this type of herbal medicines in anticipation of their effects for contraction of residual tumor and preventive effects against recurrence. It is worth noting that favorable results have been observed in 6 of the 10 patients receiving Chinese medicines whose therapeutic responses could be evaluated.

著者

川井田 政弘 福田 宏之 川崎 順久 塩谷 彰浩 酒向 司 辻 ドミンゴス 浩司 甲能 直幸

出版者

The Japan Society of Logopedics and Phoniatrics

雑誌

音声言語医学 (ISSN:00302813)

巻号頁・発行日

vol.32, no.1, pp.11-17, 1991

被引用文献数

1 2

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非特異性喉頭肉芽腫の5例に対して副腎皮質ステロイド薬の吸入療法を主体とした保存的治療を行った.3例が挿管性, 他の2例が特発性の肉芽腫であった.挿管性肉芽腫の1例はネブライザーを用いて, dexamethasoneの吸入を行ったところ, 約6ヵ月間で治癒した.他の4例はbeclomethasone dipropionate inhaler (BDI) を用いて外来通院で治療したところ, 約1ヵ月ないし3ヵ月半で治癒した.なお, 全例とも不要な咳払いや大声を避けるように指導した.非特異性喉頭肉芽腫の発生原因として, 声門後部の微細な損傷と咳嗽や咳払いによる同部の強い閉鎖に起因する悪循環が考えられた.副腎皮質ステロイド薬の吸入療法では抗炎症作用による直接作用とともに, 間接作用としてこの悪循環を断ち切ることも効果発現に関与していることが考えられた.このうち, BDIの吸入療法は外来でも簡便に行うことができ, 治療法のひとつとして有用と思われた.

著者

斉藤 成司 福田 宏之 北原 哲 小野 博

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.17, no.3, pp.79, 1976-10-25 (Released:2010-06-22)

被引用文献数

3

著者

福田 宏之 斎藤 成司 都築 達 牟田 弘 高山 悦代 藤岡 正 鈴木 理文 北原 哲 磯貝 豊 粉川 信行 市川 忠 牧野 克巳

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.2, pp.101-106, 1984-04-10 (Released:2010-02-22)

参考文献数

6

被引用文献数

4 3

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Nobody can deny that lubrication is one of the factors which influences the phonatory function of the larynx. However, no notable studies on the mechanism of lubrication have ever been carried out. This study is an effort to clarify how the larynx is lubricated.In the present study, it is revealed that the secretory fluid from the tracheal and subglottic spaces passes instantly through the glottis at the moment of the onset of phonation. Thus, the initiation of the lubrication is accomplished. The fluid from the subglottis is then mixed with the supraglottic fluid which comes mainly from the ventricular gland. A lubricant column is bilaterally made by the mixed fluid on the upper surface of the vocal folds. This lubricant column is rotating perpendicularilly to the free edge of the folds. The lubricant column may lubricate the folds which vibrate during phonation. At the end of phonation, the column decomposes and mostly flows backward to the subglottis. By this flow, the glottis is lubricated again.In this paper, the results mentioned above were discussed and analyzed from the viewpoint of phonodynamics.

著者

福田 宏之

出版者

特定非営利活動法人 日本頭頸部外科学会

雑誌

頭頸部外科 (ISSN:1349581X)

巻号頁・発行日

vol.3, no.2, pp.119-124, 1993-11-26 (Released:2010-07-27)

参考文献数

7

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早期声帯癌に対しては,放射線療法,内視鏡下レーザー治療,声帯切除などが試みられる。いずれも一長一短あり適応を間違えなければそれぞれ優れている面がある。喉頭を切開して患側声帯を切除するのが切除範囲を決めたり,確実に切除するのに適している。しかしこの場合の欠点は残された音声に相当の障害が残ることである。それは声門閉鎖不全のため気息性の強い嗄声となるためである。そこで同側仮声帯の後部を茎とする筋粘膜弁を作成し,声帯を切除した跡地に移動,縫合して新しい声帯を作り声門閉鎖不全を防ぐ再建手術を考案した。声帯切除と同時に行えるので患者は術後一週間程度で会話可能である。

著者

福田 宏之 川井田 政弘 大木 和明 加納 滋 川崎 順久 辻 ドミンゴス浩司 甲能 直幸

出版者

The Keio Journal of Medicine

雑誌

The Keio Journal of Medicine (ISSN:00229717)

巻号頁・発行日

vol.39, no.2, pp.102-105, 1990

被引用文献数

2

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The phonatory examination was performed while monitoring vocal fold vibration by laryngostrobovideography. Vocal fold vibration was video-taped by a laryngostroboscope and flexible laryngofiberscope inserted through the nasal cavity. Simultaneously, the phonatory examination was conducted with a phonation analyzer. The data were entered into a personal microcomputer via an A/D converter and analyzed to obtain the parameters of sound pitch, sound intensity and mean expiratory air flow volume, which were superimposed on the color video monitor screen.

著者

川崎 順久 福田 宏之 辻 ドミンゴス浩司 大築 淳一 高山 悦代 磯貝 豊

出版者

耳鼻と臨床会

雑誌

耳鼻と臨床 (ISSN:04477227)

巻号頁・発行日

vol.36, no.6, pp.1232-1235, 1990

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喉頭の非特異性肉芽腫と声帯後部のsevere dysplasiaと診断され外科的鉗除を行つて経過観察中に5年3カ月後に肉芽腫上皮から扁平上皮癌が証明された1症例を報告した. 喉頭の非特異性肉芽腫は再発しやすい炎症性腫瘤であるが, 本症例のように悪性化することもあり, 自覚症状や音声障害が少ないからといつて放置せず, 声帯全体を十分に観察し治癒するまで経過観察を続けることが重要である.