著者

綱 由香里 井上 彰子 松島 康二 細野 祥子 和田 弘太

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.32, no.02, pp.213-217, 2020-12-01 (Released:2021-05-11)

参考文献数

13

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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 diagnosed with NGTS. Larynx electromyography reduced the interference pattern in the right thyroarytenoid muscle. Neuroparalysis was also suggested as a pathosis of NGTS.

著者

川嶋 隆久

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.17, no.2, pp.56-60, 2005-12-01 (Released:2012-09-24)

参考文献数

13

被引用文献数

1

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Acute epiglottitis, as well as airway management of this malady in adults, can rapidly deteriorate into an airway obstruction. This potential emergency demands prompt evaluation of the epiglottis with an emphasis on vigilant and proficient attention to airway management. During the examination, the patient should be in a sitting position while under intense observation in preparation for tracheal intubation at any time. For patients affected by respiratory distress, ventilation with 100% O2 and urgent intubation are needed. Choose 1 or 2 sizes smaller than the usual tube size for intubation. Oral intubation along with administration of a sedative and muscle relaxant is comparatively safe and easy. However, in cases where : 1) difficulty in airway establishment is anticipated, 2) SpO2 does not elevate in spite of enough O2 supply, or 3) the patient is already in shock, a sedative or muscle relaxant would precipitate respiratory arrest. In such cases, consider whether oral intubation without a sedative or muscle relaxant or nasal intubation with an endoscope can be performed. Nasal intubation with an endoscope in a sitting position might be effective. For the patient in agony or with difficulty in opening their mouth, intubate after administrating a little amount of sedative while monitoring blood pressure and SpO2. If it is difficult to establish their airway rapidly, administrate vecuronium and choose oral tracheal intubation while being prepared for implementing an emergent tracheotomy, or a cricothyroidotomy; either needle or surgical. If unable to intubate successfully, ventilate with the bag-valve-mask technique with 100% O2 as far as possible, then provide an emergent tracheotomy, needle or surgical cricothyroidotomy immediately.

著者

片岡 英幸 森川 茂廣

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.1, pp.1-4, 2002-06-01 (Released:2012-09-24)

参考文献数

3

---

The Shiga University of Medical Science installed the first intraoperative MR unit in Japan, the GE SIGNA SP/i 0.5 T, and began clinical studies starting January 2000. This system, called a double-doughnut type open MR system, was designed especially for minimally invasive MR-guided surgery and interventional therapy. The MR imaging of the GE SIGNA SP/i 0.5 T is characterized by superior soft tissue discrimination and flexible MR planes.We report here on the use of this intraoperative MR system to assess vocal fold medialization by thyroplasty and arytenoid adduction. Intraoperative MRI can repeatedly assess by axial and coronal planes, and provided additional information about bilateral vocal fold symmetry, medial-to-lateral displacement, heights of both vocal folds, and the orientation of implants. An Intraoperative MRI unit is useful in assessing several aspects of vocal fold medialization procedures.

著者

田口 亜紀 竹下 小百合 長谷川 琴音 城本 修 土師 知行

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.32, no.02, pp.117-124, 2020-12-01 (Released:2021-05-11)

参考文献数

6

---

The high-pitched blowing exercise is a technique for conducting water resistance with high-pitch voice. This exercise is one of semi-occluded vocal tracts (SOVTE). When we performed high-pitched blowing through a laryngoscope in cases where high-pitched vocalization was difficult, the interval of posterior glottis disappeared, and the voice function also improved.We conducted a detailed examination of the voice pitch for water resistance. The subjects were 40 healthy young women currently attending our school (age: 19-22 years old), randomly divided into 4 groups: Silent Group, Speaking Voice Group, Chest Voice Group, and Head Voice Group. The examination items were the duration of water resistance before/after training, maximum phonation time (MPT), phonatory function test, physiological voice range, acoustic analysis, and subjective evaluation. As an additional study, we also measured the open quotient (OQ) by a photoglottogram (PGG). We observed no marked changes in the Silent Group before/after training. Regarding the phonatory function test findings,were recognized improvement in the MPT, amplitude perturbation quotient, harmonics-to-noise ratio, and voice handicap index. For the PGG, 25% OQ indicated a favorable level in the Head Voice Group. These findings suggested that the high-pitched blowing exercise was more effective than ordinary water resistance for voice disorder.

著者

中島 格 田中 資介

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.1, no.2, pp.83-88, 1989-12-01 (Released:2012-09-24)

参考文献数

20

---

The local immune system of human laryngeal tissues was reviewed. Attention was focused to the distribution pattern of the glandular tissue and SIgA production in each structure of the larynx. Glandular acini and ductules were distributed mainly at the level of the false vocal colds and sub-glottis. Glandular buds made their appearance in fetal larynges. IgA and other immunoglobulins were found in adult larynges. In fetal larynges, however, IgA and secretory IgA could not be detected. In adults, diffuse fluorescence for IgA was observed not only in the submucosal or peri-glandular connective tissue but also in the glandular tissue. IgA producing plasma cells were numerous. Secretory component (SC) synthesis was found in the glandular acini and epithelium. SC synthesis was noted also in the glandular tissue of fetuses. These observations indicate that, in human larynges, the local immune function conducted by SIgA starts working shortly after birth.

著者

粕谷 英樹

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.57-63, 2002-12-01 (Released:2012-09-24)

参考文献数

13

---

Speech analysis methods can be divided into two classes, parametric and nonparametric. The parametric method includes a speech production model in the analysis process, while the nonparametric method does not. The former is exemplified by the well-established linear prediction analysis and the latter often utilizes short-term Fourier analysis. Recent progress in speech analysis methods can be found in an ARX (Auto-regressive with exogenous input) method, a parametric approach, as well as STRAIGHT (Speech Transformation and Representation using Adaptive Interpolation of weighted spectrum) method, a nonparametric approach. The ARX method incorporates a sophisticated ARX-based speech production model, making it possible to separately estimate glottal flow parameters and formants. Basic and clinical applications of the ARX method are presented in the field of voice and speech disorders, including acoustic evaluation of dysarthria, esophageal voice and dysphonia.

著者

小島 美子

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.9, no.2, pp.91-95, 1997-12-01 (Released:2012-09-24)

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When we speak of traditional Japanese music, we are refering to a variety of music ···from artistic music to folkloric music. Despite the variety, there are certain characteristics running through them in terms of the Japanese sensibility toward music. It is this musical sense of the Japanese that will provide an important base for the new Japanese music to develop in the future.A sense of rhythm is determined over a long period of certain group's history by the way how they have used their physical body. A majority of the Japanese, for instance, have a “static” sense of rhythm characteristic of the rice paddy farmers. People in the mountains, on the other hand, use their limbs in a flexible way, resulting in a “supple” sense of rhythm. People who live on the islands of Okinawa and Amami, as well as people who live on coastal areas, have a “swinging” sense of rhythm in correspondence to the undulation of ocean waves.A sense of timber is determined over a long period of time by the kind of life style and natural environment people live in. People in Japan have lived mainly by farming and fishing in a climate where the four seasons are distinct. Consequently they developed sharp sensitivity toward changes in weather, making them alert to natural sounds such as a rain and a wind. It is for this reason that the Japanese favor songs and instruments that sound close to natural sounds.Japanese melodies and based on six pentatonic scales. Each consists of two sets of the perfect fourth called the tetrachord. These scales have much in common with the music of Asia and Africa.The Japanese subconsciously feel, though vaguely, the presence of a god or spirit in every object. Such a tendency, or a habit of the mind, is also revealed in music and songs. This attitude, which may correspond to the idea of symbiotism, is demonstrated in the Japanese way of thinking that songs too possess spiritual power.

著者

楯谷 一郎 平野 滋 伊藤 壽一

出版者

THE JAPAN LARYNGOLOGICAL ASSOCIATION

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.22, no.2, pp.67-70, 2010-12-01 (Released:2011-04-08)

参考文献数

13

被引用文献数

1

著者

佐藤 公則

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.30, no.2, pp.57-65, 2018-12-01 (Released:2019-06-17)

参考文献数

29

---

1. Phonosurgery is performed on the human larynx to treat phonatory dysfunction and improve the quality of voice. 2 . There are two major categories of phonosurgery. One surgical option is open-neck laryngeal surgery, which is performed via an extralaryngeal approach. The other is endolaryngeal microsurgery and endoscopic surgery, which are performed via an intralaryngeal approach. 3. When performing phonosurgery via an extralaryngeal approach, it is very important to be able to visualize the internal laryngeal structures by looking at the laryngeal cartilage. Furthermore, when performing phonosurgery via an intralaryngeal approach, it is important to be able to visualize the internal laryngeal structures, including histoanatomy, by observing the mucosa of the lumen. An understanding of the histologic structures of the vocal fold is also essential when performing phonosurgery. 4. Knowledge of the three-dimensional structure, histology and histopathology of the larynx is indispensable when performing phonosurgery.

著者

石田 愛 永井 世里 小山 新一郎 江崎 伸一 濱島 有喜 村上 信五

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.29, no.1, pp.14-16, 2017-06-01 (Released:2017-10-27)

参考文献数

10

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Vocal cord paralysis often occurs due to unknown reasons. Since bilateral paralysis can cause dyspnea,we have to carefully watch the state of the patient while investigating the causes of paralysis. We herein report a case of bilateral vocal cord paralysis in a patient who was a vegetarian. The patient’ paralysis was improved by the administration of mecobalamin.

著者

二藤 隆春 山内 彰人 上羽 瑠美 山岨 達也

出版者

THE JAPAN LARYNGOLOGICAL ASSOCIATION

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.24, no.2, pp.97-99, 2012-12-01 (Released:2013-05-10)

参考文献数

13

著者

川副 みちる 前山 忠嗣 和田 繁 進 武幹

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.1, no.2, pp.93-95, 1989-12-01 (Released:2012-09-24)

参考文献数

7

被引用文献数

1 1

---

Noradrenergic nerve fibers contribute to the sympathetic control of blood flow and glandsecretion. Distribution of noradrenergic nerve fibers in and around canine vocal folds was investigated by means of the fluorescence method. In addition, the spatial relationship of noradrenergic nerve fibers to the blood vessels and glands was determined with the use of the peroxidase anti-peroxidase method. Noradrenergic nerve fibers were found around arteries and arterioles whose diameter was 15μm or greater. No noradrenergic fibers, however, were observed around capillaries and veins. In the laryngeal glands, noradrenergic nerve fibers were observed adjacent to the arteries which entered the glands and near the basement membrane of acinous cells. The results suggest that noradrenergic nerve fibers regulate the blood flow in the arteries and arterioles and gland secretion in the larynx.

著者

小山 新一郎 川北 大介 近藤 雅幸 吉岡 正展 村上 信五 吉田 梨帆

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.18, no.2, pp.146-148, 2006-12-01 (Released:2012-09-24)

参考文献数

5

被引用文献数

1

---

We reported on a rare case of morning glory seeds as bronchial foreign bodies. The patient was a five-month-old male infant. He accidentally inhaled morning glory seeds after placing them in his mouth and coughing. The consulting doctor diagnosed that he had caught a cold after examining a chest x-ray image and observing normal sounding respiration. Three days later, his body temperature was 40 degrees and his cough was persisting. Medical consultation was sought again. His chest x-ray revealed that the mediastinum had moved to the right side and the left pulmonary field had inflated abnormally. CT imaging clearly indicated foreign bodies in the left bronchus. We performed a ventilation bronchoscopy. His left bronchus was obstructed by morning glory sprouts. After we removed the sprouts, the child's respiratory sound and chest x-ray results improved. We determined that the morning glory seeds had germinated in the warm and wet bronchus and the enlarged seeds had obstructed his left bronchus.

著者

菊池 淳

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.17, no.1, pp.1-6, 2005-06-01 (Released:2012-09-24)

参考文献数

12

被引用文献数

1 1

---

For the purpose of studying the clinical characteristics of vocal fold bowing, the correlation between the quantitative analysis and vocal function tests was investigated in 287 patients with unilateral recurrent laryngeal nerve paralysis. Parameters for the quantitative analysis included patient's age, sex, period of unilateral recurrent laryngeal nerve paralysis, fixed position of the vocal fold, cause of paralysis, and degree of aspiration. For vocal function tests, phonatory parameters (MPT, MFRc, SPLrange, FOrange) and acoustic parameters (PPQ, APQ) were analyzed. The following results were obtained : 1) The vocal fold bowing ranged from 5% to 15% in most (236 of 286) cases with the average being 11.5%. 2) The degree of vocal fold bowing increased from the age group of forty or older. 3) The degree of vocal fold bowing showed a tendency to decrease from 270 days after the onset of recurrent laryngeal nerve paralysis. 4) In the vocal function tests, FOrange, PPQ, APQ showed a relationship to the degree of vocal fold bowing.

著者

松島 康二 金沢 英哲 一色 信彦 田辺 正博 枝松 秀雄

出版者

THE JAPAN LARYNGOLOGICAL ASSOCIATION

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.23, no.1, pp.26-29, 2011-06-01 (Released:2011-09-01)

参考文献数

12

被引用文献数

3 2

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The Type 1 Thyroplasty or Medialization Thyroplasty was first reported in the 1970s by Isshiki et al for treating voice disorders resulting from vocal fold paralysis or atrophy. Since then, this therapeutic modality has gained world-wide popularity, and a number of modified methods were also reported with generally satisfactory results.Silicone block fabricated in situ had long been utilized to fix the window cartilage without any significant complication, however, containment failures from silicone bag breast implants and their resultant negative side-effect led to difficulties in obtaining silicone for any surgical treatment whatsoever. Gradually, Gore-tex, as used for correcting vascular problems, had replaced silicone, because of its ease in handling and of its excellent biocompatibility. However, it did not guarantee precision in the adjustment of medialization, especially when the window-cartilage was removed and/or when the Gore-tex sheet was packed in a wrong direction. In this respect, Titanium, well known for its excellent biocompatibility, seems better suited for precision and long-lasting effectiveness. Friedrich had already reported excellent results. Based on our abundant experience with Titanium Bridges in type 2 thyroplasty for spasmodic dysphonia, we utilized a simple thin and bendable Titanium plate so as to realize adequate medialization on site.

著者

鹿野 真人 高取 隆 小針 健大 佐藤 廣仁 木田 雅彦

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.28, no.1, pp.16-23, 2016-06-01 (Released:2016-10-28)

参考文献数

24

被引用文献数

12 13

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In 2007, we reported a newly-developed surgical airway-opening technique(cricoid fenestration)using a partial resection of the cricoid cartilage to form a stoma. From 2006 to 2014, a total of 57 cricoid fenestration procedures were performed at our hospital. The reasons for surgery included cervical disturbances such as low-set larynx, obesity, short neck, thyroid tumor, cervical abscess, and tortuous brachiocephalic and common carotid artery. Surgeries were also performed in high-risk patients who required long-term airway management, hemostasis, and urgent airway establishment. In this study, only one patient developed subcutaneous emphysema as an intra- or postoperative complication.Cricoid fenestration enables us to easily create a stoma at a higher level of the cricoid cartilage without transecting the thyroid gland. In addition, this technique can quickly establish a controlled airway with a low risk of intraoperative bleeding. Finally, long-term airway management can be performed easily using this technique without tube-related complications including scarring or stenosis, despite the resection of the cricoid cartilage. Cricoid fenestration is therefore considered to be a safe and effective surgical airway-opening technique.

著者

室野 重之

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.33, no.02, pp.86-88, 2021-12-01 (Released:2022-03-25)

参考文献数

15

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Although laryngo-tracheal papilloma, also known as recurrent respiratory papillomatosis, is a benign disease, it tends to recur and spread throughout the larynx and trachea. The incidence rate in Western countries has been reported to be less than 1 per 100,000 for both juvenile-onset and adult-onset types. Surgical approaches to managing this disease have varied over time. For example, a carbon dioxide laser was the most popular modality in the 1990s in the United States, whereas a microdebrider has been widely used since the 2000s in both the United States and Europe. Our previous survey revealed that a carbon dioxide laser, microdebrider, and cold steel surgery were used with almost equal frequency in Japan. We are currently conducting a nationwide survey that will help clarify the epidemiology of this morbid disease in Japan. The disease is caused by human papillomavirus (HPV), especially the low-risk types of HPV6 and HPV11. Therefore, the 4- and 9-valent HPV vaccine may reduce the incidence of this disease, as observed in anogenital warts.

著者

田口 亜紀 有友 宏

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.32, no.01, pp.37-42, 2020-06-01 (Released:2020-09-04)

参考文献数

9

被引用文献数

1 1

---

We successfully developed the Taguchi method as the short version of Vocal Function Exercise (VFE). The Taguchi method involves only the following training contents included in VFE: Extension of phonation time, and phonation exercise with a certain voice pitch. We applied this method to a series of voice disorder cases. Patients treated with the short version of VFE were typically in their 60s and 70s, often with vocal cord atrophy and sulcus. The number of training sessions and the training period duration were ≤6 times and ≤3 months, respectively, so treatment was completed in a shorter period of time than with the original VFE method. We also noted an improvement in the auditory impression, maximum phonation time, and Voice Handicap Index (VHI) in most cases with the short version of VFE compared to before therapy. The short version of VFE can be accomplished with a simple procedure and is expected to shorten the treatment period.

著者

宮本 真 宮田 恵里 岩井 大 友田 幸一

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.29, no.2, pp.90-93, 2017-12-01 (Released:2018-06-08)

参考文献数

17

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The vagus nerve is one of the 12 cranial nerves, which is considered as the 10th nerve. The vagus nerve extended from the medulla oblongata to the second segment of the transverse colon. This nerve innervates the majority of the muscle of the pharynx, soft palate and larynx. In cases of vagus nerve paralysis, palatal arch movement is restricted. The arches cannot move up and back in order to close off the nasopharynx. This causes hoarseness, nasal speech, aspiration and regurgitation of liquid through the nose. In this article, we report 10 cases of the vagus nerve paralysis. The patient’ mean age is 59.4 (range 34-83). There were 5 male and 5 female patients, among which there were 6 cases of right and 4 cases of left side paralysis. In six cases the chief complaint was vocal disorders. The causes included 5 cases of Varicella-Zoster virus infection (all confirmed) and 4 cases of central paralysis. In 9 cases of the 10 patients, nasopharyngeal incompetence, elevation or constriction of the paralyzed side and saliva pooling in the pyriform sinus were observed. In 4 cases of the 10 cases, the vagus nerve paralysis improved after treatment within 6 months. In cases of vagus nerve paralysis immediate and accurate diagnosis and treatment are crucial. It is important to observe the palatal arches as they contract and the soft palatal as it swings up and back in order to close off the nasopharynx.

著者

平野 実

出版者

THE JAPAN LARYNGOLOGICAL ASSOCIATION

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.25, no.2, pp.58-65, 2013-12-01 (Released:2014-07-25)