著者
木村 美和子 千原 康裕 二藤 隆春 田山 二朗
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.57, no.6, pp.502-507, 2006 (Released:2006-12-25)
参考文献数
6
被引用文献数
3 2

ムンプスの合併症として,呼吸困難や咽喉頭浮腫は報告が少ない。今回われわれは咽喉頭浮腫を合併したムンプスの2症例を経験したので報告した。 症例は26歳男性と36歳女性。初診時より顎下部耳下部の腫脹,呼吸困難を認め当院救急外来受診,喉頭ファイバースコープにて咽喉頭に浮腫を呈しており入院となった。頸部CTでは,顎下腺,耳下腺とその周囲にびまん性の腫脹を認め,咽喉頭の浮腫状腫脹が著明であった。血液検査でWBC・CRP正常範囲内,血清アミラーゼ高値を認めた。ステロイド投与により呼吸困難は改善し退院した。その後の検査でムンプスウィルスIgM陽性を確認した。 2症例ともステロイド投与で咽喉頭浮腫は軽減し,気管切開を回避することができた。咽喉頭浮腫の原因は,顎下腺とその周囲軟部組織の炎症性浮腫により,二次的に咽喉頭から流出するリンパ管がうっ滞して循環障害を起し,咽喉頭粘膜にうっ血性の浮腫が生じたためと推察した。 咽喉頭浮腫を合併したムンプスの成人例を2症例報告した。耳鼻咽喉科の臨床現場では頸部腫脹と咽喉頭浮腫を合併した症例にしばしば遭遇するが,ムンプスウィルス感染の可能性も鑑別診断の1つにあげる必要があると考えられる。
著者
井上 真規 小河原 昇 田辺 輝彦 大石 公直 佃 守
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.62, no.6, pp.533-537, 2011

昭和60年以降に当科で診断された若年型喉頭乳頭腫4例において臨床症状・喉頭所見・治療内容・治療経過・分娩方法・出生順位で検討を行った。全例に嗄声を認め腫瘤は喉頭に多発していた。LMS·CO<sub>2</sub>レーザー治療施行後も全例で喉頭に再発がみられたが数回のLMS·CO<sub>2</sub>レーザー治療で2例は治癒した。1例は転居のため経過は不明で1例は経過観察中である。本疾患の病因はHPV (human papilloma virus) の経産道感染といわれ,発症の危険因子として経膣分娩や第1子などがあげられる。当科での4例では全例経膣分娩で2例が第2子,他は第1子,第3子であった。若年性喉頭乳頭腫は多発性で再発を繰り返し治療に難渋することが多いが,再発を繰り返した症例において,短期集中のLMS·CO<sub>2</sub>レーザー治療が有効であると思われた。
著者
山田 文則
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.10, no.4, pp.212-230, 1959-10-10 (Released:2010-02-22)
参考文献数
15
被引用文献数
5 5

The larygeal, tracheal and syringeal muscles of several birds (Gallus gallus var. Domesticus Brisson, Otus asio Teminck & Schlegel, Melopsittacus undulatus and Corvus levaillantii japonensis) were observed anatomically under binocular microscope, in paying attention to that the tone production of birds are performed not by larynx but by syrinx, and these muscles originate from the sterno-hyoid muscle system. Following results are obtained:-1 The laryngeal muscles are classified in delator and constrictor. The constrictor muscles are different according to the kind of birds, yet M. crico-arytenoideus lateralis, M. cricoideus dorsalis, and M. interarytenoideus are discriminated.2 Gallus gallus var. domesticus Brisson and Otusasio T. & S. make their tracheas move up and downby working M. sterno-trachealis and M. tracheo-lateralis to shut and open the space between the internal and external tympaniformic membrane, and by this movement the tone production and respiration are performed.3 Melopsittacus undulatus are absent of M. sterno-trachealis, but M. tracheo-lateralis, M. tracheo-bronchialis, and M. syringecs contribute to the movement of syrinx.4 Syringeal muscles of Corvus levaillantii japonensis are classified in M. cleido-trachealis, M. tracheo-lateralis, Mm. tracheo-bronchiales, M. tracheo-bronchialis dorsalis brevis, and Mm. syringei.5 The laryngeal muscls are chiefly innervated with glossopharyngeal nerve. The muscles connected with syrinx are controlled doubly by the upper and lower laryngeal branch of the hypoglosso-cervical nerve and the syringeal branch of the recurrent nerve.6 The syringeal branch of the recurrent nerve does not anastomose with the upper laryngeal branch of the hypoglossal nerve, going to among the muscle bundles of the tracheo-laterl muscle, and anastomoses with the branch of the glossopharyngeal nerve at the upper portion of the trachea. I confirmed this in Gallus gallus var. domesticus Brisson, Otus asio T. & S. Melopsittacus undulatus.
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

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

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
唐帆 健浩
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.50, no.3, pp.396-409, 1999-06-10 (Released:2010-02-22)
参考文献数
40
被引用文献数
10 7

The purpose of this study was to determine the effect of the “chin-down” maneuver on the swallowing function. Ten normal volunteers were examined with videofluorography and manometry in both the neutral and the “chin-down” positions. The effect of this maneuver on the pharyngeal dimensions, hyoid motion, bolus flow, and manometric pressures at the base of tongue (BOT) was evaluated using 5ml of barium.The “chin-down” maneuver significantly decreased the distance between the epiglottic tip and the posterior pharyngeal wall (PPW); the distance between the epiglottis and the arytenoid; the vallecular angle; the duration of the upper esophageal sphincter (UES) opening; and the duration of the anterior hyoid movement. The “chin-down” maneuver increased the epiglotto-tracheal angle; the duration of laryngeal closure; the duration of the BOT-PPW contact; the duration of the hyoid rest period in a maximal excursion; the maximum diameter between the anterior and the posterior wall of the UES; the peak pressure at the BOT; the duration of the pressure wave at the BOT; and the area under the curve of contraction at the BOT.These results show that the “chin-down” maneuver advances airway protection, UES opening and the propelling force at the BOT during swallowing in normal volunteers. This maneuver may have a therapeutic value for treatment of dysphagic patients.
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

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.

2 0 0 0 OA 頸部の解剖

著者
平野 実
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.38, no.6, pp.528-529, 1987-12-10 (Released:2010-02-22)
参考文献数
2
著者
三枝 英人 小野 卓哉 林 明聡 豊田 雅基 新美 成二 八木 聰明
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.48, no.4, pp.297-302, 1997-08-10 (Released:2010-02-22)
参考文献数
14

The treatments for patients with severe dysphagia and misdeglutition are very difficult. Some cases must have total laryngectomy or tracheo-esophageal separation to control their severe misdeglutition and prevent serious respiratory distress. However, in such cases, the phonatory function has to be sacrificed, resulting in a poor quality of life.In order to overcome this conflict between deglutition and phonation, we have developed an “artificial pharynx.” The artificial pharynx consists of a soft balloon and a plastic tube. The soft balloon is attached to a tube with an inlet hole. The whole assembly can be inserted through the patient's nose. The tip of the tube remains in the stomach and the balloon is inflated at the level of the pharynx to seal the airway. Our patient could breathe through a tracheal stoma which was created prior to using the artificial pharynx. The bolus was introduced through the inlet hole into the tube and moved down to the stomach by gravity. When the balloon was deflated, the patient could breathe and phonate with a speech valve of the cannula.We treated a patient using an artificial pharynx. He was a 62 years old male diagnosed as having terminal myotonic dystrophy and suffering from severe dysphagia. Because of his poor general condition, any surgical intervention for dysphagia and misdeglutition could not be performed without a tracheotomy. But, since he yearned to take some drinks and to preserve his phonatory function, the artificial pharynx was utilized with some success.
著者
古賀 慶次郎 川城 信子 荒木 昭夫 越永 重四郎
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.42, no.4, pp.323-329, 1991-08-10 (Released:2010-10-20)
参考文献数
10
被引用文献数
1

During the period between 1971 and 1980, the postmortem examinations of 14 infants and young children, ranged from 9 months to 4 years of ages, averaged 1-year-7 month old, who died of foreign bodies in the airway were performed in the Tokyo Metropolitan Examiners Office. The clinical progress of these children was reviewed, and summarized as follows.1. The foreign bodies in these cases were several kinds of foods such as beans in 5 cases, orange or its skin in 2, other foods in 3 and a candy in one case.2. Among these, two chidren were eating foods while they were playing or running around, and 3children aspirated foreign bodies into the airway accidentally during vomiting or unknown cause and while changing their dipers.3. These accidents have tought us that it is very important to feed or give foods to children while they are quiet.4. Ten children have died at the day of accident, and 3 children have been transferred from clinic to clinic and died in several days after the accident. Every phisician who happens to see children presenting with wheezing or respiratory distress should be aware of foreign body in the airway.5. In 13 cases, foreign bodies were found in the trachea. The case of foreign body in the trachea usually shows a normal chest X-ray and this makes the precise diagnosis much more difficult than cases with a foreign body in the bronchus. The fiberscopic or bronchoscopic examinations are mandatory for making the exact diagnosis.
著者
福山 智子 湯田 厚司 山田 弘之 原田 輝彦 坂倉 康夫
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.45, no.6, pp.462-466, 1994-12-10 (Released:2010-02-22)
参考文献数
9
被引用文献数
1

We report a case of esophageal perforation caused by a piece of glass in a 34-year-old woman suffering from sudden severe pharyngeal pain. We found a foreign body lodged at the esophageal wall 4cm below from the first esophageal constriction upon X-ray and flexible fiberscopic examination. The foreign body was removed using a rigid esophagoscope 39 hours after swallowing. The foreign body was an equilateral triangular piece of glass whose side was 30mm. Immediately after the foreign body was removed, we found an esophageal perforation, subcutaneous emphysema and pneumomediastinum. The perforation was closed using an external approach. The patient showed improvement after the operation.

1 0 0 0 梅核気

著者
松塚 崇
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.69, no.4, pp.268-269, 2018-08-10 (Released:2018-08-25)
参考文献数
9
著者
佐藤 靖雄 森田 守 高橋 広臣 蔵内 祥博 黄川田 光夫
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.16, no.4, pp.160-167,en1, 1965 (Released:2010-10-20)
参考文献数
29

Two cases of carcinoma of the larynx, which were found in teenagers, were reported: a fourteen year-old girl supralottic type, squamous cell carcinoma, Stage III (T2N1M0) and a seventeen year-old girl (glottic Type, carcinoma in situ, Stage I (T1N0)). The former was treated with irradiation followed by surgery, and in the latter, radiation only. The vocal cords were saved in both cases. No recurrance of tumor is seen for one and half year in the former case and six months in the latter after treatment. The followings are discussed: how to combine radiation therapy and surgical treatment, concerning skin incisions of partial resection, regional application of anti-cancerous drugs, and the functions of speech and swallowing after surgery.
著者
佐藤 公則 川口 壽郎 松岡 秀隆
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.4, pp.292-299, 1990-08-10 (Released:2010-10-20)
参考文献数
14
被引用文献数
4 4

Four patients with esophageal or hypopharyngeal perforation caused by endoscopy treated from 1981 through 1989 at Kurume University Hospital, are reviewed.1) All the patients were adult, two were male and two were female.2) The cause was by flexible fiberscopy in two patients with hypopharyngeal perforation, by rigid esophagoscopy in two patients with esophageal perforation. The lesion of hypopharyngeal perforation was left piriform sinus and that of esophagus was entrance of cervical esophagus.3) All the patients were treated surgically. Primary suture of the peforation was done in one case.4) All the patients were cured.5) The most useful examination was a lateral view of the cervical X-ray.6) From our experience, the following treatment is recommended. Operation should be done as soon as possible, and primary suture of the perforation would be done if possible. The operative wound should be opened, and oral administration of foods would be started if possible. And the operative wound could be successively closed if there were no problems.
著者
村上 直子 原 浩貴 山下 裕司
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.55, no.1, pp.43-47, 2004

喉頭肉芽腫は声帯突起部に好発する炎症性の腫瘤であるが,しばしば再発し治療に難渋することのある疾患である。今回我々は喉頭肉芽腫の9症例に対しレバミピドとセラペプターゼの2剤併用の内服加療をおこなった。その結果,9例中5例(56%)で肉芽腫が消失した。肉芽腫消失までの期間は最短で21日,最長で91日であった。5例中3例は術後再発の症例であった。また1例はPPIの無効例であった。また5例全例とも投与後に最短10日,最長28日で肉芽腫の縮小効果が確認された。消失した5例で,内服終了後に再発したものはなかった。<br>今回の結果から,喉頭肉芽腫が消失した原因は主として血中レバミピドの炎症抑制作用が喉頭粘膜に影響を及ぼしたためではないかと推察した。また無効であった4例では,血中濃度が充分でなかった可能性と,レバミピドでは胃酸逆流の防止が困難なほど重度なGERDが潜んでいた可能性を推察した。
著者
伊藤 裕之
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.40, no.4, pp.357-360, 1989
被引用文献数
1 1

This report is concerned with diet for dysphagic patients. Oral intake of foods was very important as rehabilitation training for dysphagia. However, some foods which are difficult to swallow for patients might cause air way obstruction and pneumonia. Therefore the choice of suitable diet was essential for the rehabilitation of dysphagia. Though adequate foods for dysphagic patients were slightly different, case by case. They are generally wet, easy to masticate and favorite of the patients. On the contrary, unsuitable diet, is dry and spicy. The foods containing too much water and unfavorite ones of the patients are not adequate for dysphagic patients. A program of diet for dysphagic patients were proposed and tried on a patient of dysphagia. Oral feeding was begun with soft and wet foods such as pudding, yoghurt and "chawan-mushi" as the first step and baby foods were chosen in the next step. In the third step, well-boiled soft vegetables or "toufu" (bean curd) were added to foods of the second step. In the forth step, gruel were added to the previous step. The foods should be chosen according to the improvement of the dysphagia. The diet program for dysphagic patients should be established.
著者
真栄田 裕行 嘉陽 祐紀 金城 秀俊 上里 迅 安慶名 信也 又吉 宣 鈴木 幹男
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.70, no.1, pp.30-37, 2019

<p>今回われわれは気管内壁に再発した頸部気管支嚢胞腺癌の1例を経験した。症例は71歳の女性。甲状腺全摘術および頸部郭清術後ほどなく気管内壁に再発した。腫瘍切除後の気管再建には肋軟骨と歯科用印象材を用いた。構造体としての強度を得るため肋軟骨片により気管外枠を作成した。また歯科用印象材を充填した手術用ゴムグローブを気管内にステントとして留置した。術後3年目腫瘍の再発は認められず,十分な強度と呼吸道としての内腔が保持された気管が再建できた。歯科用印象材は気管内腔を形成するためのステントとして有用な材料である。</p>
著者
村上 正人
出版者
特定非営利活動法人 日本気管食道科学会
雑誌
日本気管食道科学会会報 (ISSN:00290645)
巻号頁・発行日
vol.55, no.5, pp.398-403, 2004 (Released:2007-08-24)
参考文献数
14

人間の感情が動くときに象徴的な咳反応や咳症状が出現するように,咳は必ずしも気道の刺激だけではなく情緒的な刺激によっても生じることがある。いわゆる神経性咳嗽nervous coughは決して多い疾患ではないが,的確な診断と治療がなされないと,改善されぬまま慢性の経過をとりやすい。神経性咳嗽は何らかの心理的機制により,発作性,あるいは持続性に乾性咳嗽が生じるものである。しかし心因性,神経性といいながらよく病歴をとってみるとかつて急性上気道炎,咽喉頭炎や気管支炎に罹患したことが契機になり発症することが多い。長期間持続する慢性咳嗽の鑑別診断は慎重に行い,特に咳喘息との鑑別は重要である。咳反射に対する過敏性を獲得するプロセスに何らかの心理社会的ストレス要因が関与して発症するとされ,ヒステリーによる象徴的な症状(転換症状),内的緊張のはけ口としての咳,緊張時の音声チックと同様なメカニズムなどが考えられている。診断,治療に当たって,bio-psycho-socialな視点からの理解とアプローチが必要である。本症ではしばしば不安障害やうつ状態が合併しており,抗不安薬や抗うつ薬などの神経系作用薬がよく奏効することが多い。心理的要因が症状悪化につながっているときには専門的な心理療法を導入する。