著者

兵頭 政光 森 敏裕 河北 誠二 湯本 英二

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.12, no.1, pp.31-35, 2000-06-01 (Released:2012-09-24)

参考文献数

14

被引用文献数

1

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Oropharyngeal swallowing disorder results from the disruption of the integrated mechanism of deglutition. This disruption occurs when the lower cranial nerves have been paralyzed due to a cerebrovascular accident or by a skull base lesion. In this article, we postoperatively evaluated the outcomes of 26 patients who had undergone surgical intervention for severe dysphagia caused by lower cranial nerve deficits. The ages of the patients ranged from 22 to 79 years, with an average of 58 years. Etiology of dysphagia consisted of cerebrovascular accidents in 14 cases, skull base lesions in 7, parapharyngeal space lesions in 2, and others in 3. Twenty-one patients had been entirely dependent on tube feeding or intravenous hyperalimentation preoperatively. The series of surgical procedures included cricopharyngeal myotomy (CPM) in 10 cases, CPM with laryngeal suspension (LS) in 6, CPM with vocal fold medialization (VFM) in 3, CPM with both LS and VFM in 6, and VFM in 1. Twenty-three patients (88%) had success in postoperative swallowing function improvement, and oral food intake was restored. Although structured swallowing rehabilitation is mandatory for patients with pharyngeal swallowing disorders, surgical strategies should be considered as a choice of treatment for patients with prolonged pharyngeal swallowing dysfunction.

著者

嶋崎 孝嗣 吉田 義一 平野 実

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.96-103, 1997-12-01 (Released:2012-09-24)

参考文献数

38

被引用文献数

1

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Laryngeal myoclonus is a rare involuntary movement characterized by persistent, repetitive and rhythmic contraction of laryngeal muscles. It is not in itself a disease entity but is a symptom found in various diseases. Two cases of pharyngo-laryngeal myoclonus that we observed were introduced and palato-pharyngo-laryngeal myoclonus literature was reviewed. So far there have been 304 case reports from 18 months to 91 years old (avg 44.5) having a male preponderance of 59% : 41% in America and Europe, and 65 case reports (2 to 76 years old, avg 30) had a sex distribution of male 62% : female 38% in Japan. Presenting complaints were earclick, involuntary movements and abnormal sounds in the cervix and et al, and some patients had no self-evident symptom. Almost all cases of myoclonus were observed in the soft palate. One of the characteristics of myoclonus was its resistance to many influences such as medication, sleep, and even coma, while it was influenced under some conditions. MRI was useful to detect the lesions. Many pathoanatomical findings demonstrated lesions of the dantato-olivary pathway and the pseudohypertropy of the inferior olivary nucleus. The pathophysiological mechanisms are still unclear and more physiological studies are needed in order to establish treatments.

著者

井門 謙太郎 平川 勝洋 渡部 浩

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.1-7, 2017-06-01 (Released:2017-10-27)

参考文献数

18

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The clinical symptoms of perennial laryngeal allergy include a persistent cough, itching and irritation of the throat. We endeavored to shed some light on the features of antigens and laryngeal findings of perennial laryngeal allergy. A clinical study focusing on the diagnosis of laryngeal allergy was carried out in 53 patients exhibiting a persistent cough, itching and irritation of the throat. A diagnosis of laryngeal allergy was confirmed based on the effectiveness of H1-blockers and the presence of specific IgE antibodies by RAST testing. Laryngeal allergy was diagnosed according to the criteria proposed by the Society of Study for Laryngeal Allergy in Japan(2011).Seventeen of the 53 patients were diagnosed with perennial laryngeal allergy. A major positive perennial antigen in laryngeal allergy is the house dust mite. In comparison to nasal allergy, moth and cockroach antigens have a higher positive frequency with perennial laryngeal allergy.The sensitivity and specificity of nasopharyngeal smears for laryngeal allergy were 59% and 73%, respectively. H1-blockers were significantly effective with positive nasopharyngeal smears.A pale laryngeal mucosa was typical laryngeal feature in perennial laryngeal allergy cases, and patients whom antihistamines were effective tended to exhibit a pale laryngeal mucosa.

著者

森 一功 梅野 博仁

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.78-82, 2002-12-01 (Released:2012-09-24)

参考文献数

10

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Various controversial problems have been pointed out for the treatment modality for patients with cicatricious stenosis of the larynx as follows : 1) successive change of the autografted mucosa and/or skin, 2) timing of complete closure of the tracheostoma, 3) influence of puberty upon the air-way, and 4) influence of puberty upon vocal functions. Thirty-six patients more than 15-year-old and 23 patienets less than 15-year-old, both with cicatricious stenosis of the larynx, were retrospectively reviewed in this study. As a result, following conclusions were obtained.1) Autografted mucosa/skin can be alive accompanying prominent cicatricious change below the grafted mucosa/skin, suggesting this histopathological change may bring re-stenosis of the air-way. 2) The trachestoma should be closed preferably after puberty, especially for patients undergoing posterior cricoid split (PCS) maneuver. For patients without PCS complete closure in childhood may cause no serious problem. 3) Patients treated their stenosis in childhood may have no restenosis of the air-way even in adulthood. 4) Patient with laryngeal stenosis may experience voice change at puberty as like ordinary children.

著者

讃岐 徹治 一色 信彦 中村 一博 湯本 英二

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.19, no.2, pp.54-58, 2007-12-01 (Released:2012-09-24)

参考文献数

20

被引用文献数

1 1

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Thyroplasty was performed under local anesthesia on male-to-female transsexuals (MTF/GID) as well as patients with adductor spasmodic dysphonia (AdSD).There were 31 patients with MTF/GID who underwent type 4 thyroplasty during the period from 1999 to 2006. Voice fundamental frequency (F0) rose in all patients. Mean preoperative F0 was 135Hz, and postoperatively the mean value was 236Hz. Type 4 thyroplasty requires specialized skill, and was found to be effective for pitch elevation surgery in MTF/GID. Forty-one patients with AdSD underwent type 2 thyroplasty with Titanium Bridge between December 2002 and December 2005. These patients were followed up 1 year postoperatively with a questionnaire. 70% of the patients judged their voice as “excellent, ” and the remaining patients as improved to “good” or “fair”. Type 2 thyroplasty is a highly effective therapy for AdSD.