著者

鈴木 真輔 本田 耕平 石川 和夫

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.1, pp.21-24, 2007-06-01 (Released:2012-09-24)

参考文献数

13

---

Laryngeal stenosis is caused by various reasons and we are usually able to detect a cause in many cases. Occasionally we encounter a case without an obvious cause. Recently we observed such a case, and we suspected that chlorine detergent possibly caused it. The patient was a 66-year-old female whose main complaint was stridor. She had been using chlorine detergent everyday for about ten years. She had been diagnosed and treated for bronchial asthma because of the stridor. Subsequently, supraglottic stenosis was observed and it was caused by this lesion. There was no particular past history and no distinguishing pathological character in the stenosis lesion. The stenosis was removed by laryngo-fissure with a supra-hyoid approach while a surgical lumen was maintained using a core mold. She stopped using the detergent after the treatment. After sixteen months of follow-up since the operation, the patient has shown no evidence of recurrent disease.

著者

篠原 宏 清水 啓成

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.31, no.01, pp.23-27, 2019-06-01 (Released:2019-09-18)

参考文献数

8

---

It is not uncommon for otolaryngologists to encounter laryngeal edema due to infection in routine practice. However, we rarely encounter laryngeal edema caused by allergic reactions to orally ingested food.We herein report two cases of oral allergy syndrome after consumption of manuka honey candy. Both cases developed laryngeal edema and subsequent steroid administration led to the prompt improvement of symptoms. A basophil activation test for manuka honey candy was negative in both cases.

著者

喜友名 朝則 喜瀬 乗基 真栄田 裕行 又吉 宣 比嘉 麻乃 鈴木 幹男

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.24-30, 2016-06-01 (Released:2016-10-28)

参考文献数

38

被引用文献数

3

---

A laryngeal papilloma is a benign tumor that occurs due to human papilloma virus infection. Although basically benign, the lesions often recur and grow in size. Furthermore, they sometimes show malignant transformation and often suffer from treatment. We performed a retrospective clinical analysis of 15 patients with laryngeal papilloma who were treated at our department over the past ten years. As with previous reports, most cases involved adult males and occupied the glottis. Canceration only occurred in one patient. Human papilloma virus infections were detected in 14 patients. All of the cases involved with type 6 or type 11(benign types)infections. Canceration occurred in one patient who did not show infection. The treatments performed at our center included, surgical resection and/or transpiration by a CO2 laser. Recurrence was observed in some cases. This was treated with multiple surgeries. Remission was achieved by the combination of treatment under local anesthesia and adjuvant therapy. It is difficult to cure laryngeal papilloma radically because it is a viral disease. Thus, we treat the disease as follows; we first confirm the lesion with a laryngeal endoscope under general anesthesia and perform a biopsy; and then conduct resection and/or transpiration using CO2 laser. When recurrence is observed, we immediately attempt extraction or laser transpiration under local anesthesia while the lesion is small. As the number of cases increases, it will be necessary to examine surgical method and postoperative adjuvant therapies.

著者

大津 和弥 竹内 万彦

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.22, no.1, pp.22-24, 2010-06-01 (Released:2010-10-08)

参考文献数

8

被引用文献数

1 1

---

In general, the primary therapy for mutational voice disorder has been voice therapy. However, we sometimes see cases in which voice therapy does not decrease the high pitch of mutational voice disorder. We performed an Isshiki type III thyroplasty on a patient with mutational voice disorder who had been treated by voice therapy for two years without remarkable improvement of his voice. His voice pitch became much lower after the Isshiki type III thyroplasty surgical procedure. The patient's fundamental frequency (F0) decreased from 276 Hz before surgery to 126 Hz after surgery. Isshiki type III thyroplasty was found to be useful as surgical treatment for higher pitch and resulted in a voice that was satisfactory to the patient with mutational voice disorder.

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

被引用文献数

1

---

Thyroplasty was performed under local anesthesia on male-to-female transsexuals (MTF/GID) as well as patients with adductor spasmodic dysphonia (AdSD).<BR>There were 31 patients with MTF/GID who underwent type 4 thyroplasty during the period from 1999 to 2006. Voice fundamental frequency (F<SUB>0</SUB>) rose in all patients. Mean preoperative F<SUB>0</SUB> 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. <BR>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.

著者

駒澤 大吾 廣崎 真柚 長谷川 智宏 渡邊 雄介

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.129-145, 2020-12-01 (Released:2021-05-11)

参考文献数

44

---

Although it is generally accepted that phonomicrosurgery may be indicated for vocal fold mass lesions even in professional singers, the specific indications for surgery on stroboscopic findings for microlesions of the vocal folds in professional singers are not clear. The present study included 88 patients (male, n=36; female, n=52) who presented to the AKASAKA Voice Health Center with clear complaints in singing and who underwent phonomicrosurgery to resect microlesions of the vocal folds. At three months postoperatively, 102 of the total 117 subjective complaints in singing were resolved (87%). We classified five vertical locations of lesions (determined based on surgical findings) on the medial surface of the vocal folds, and statistically analyzed the differences in verticality according to the various attributes of the cases. The results showed that lesions were significantly more prevalent in the upper part of the vocal folds when the singing or disordered voice was in a high pitch and light register, while lesions were significantly more prevalent in the lower part of the vocal folds when the voice was in a low pitch and heavy register. Considering laryngeal regulation during singing, we hypothesize that lesions in the lower part of the mucosal wave-generating area are more likely to cause a malfunction in singing. A lesion in such a location can also be identified by stroboscopy, as a prominence on the medial margin in the closing phase (lesion on lower crest: LLC). Although individualized treatment is necessary, stroboscopic findings that demonstrate the presence of an irreversible LLC in singing may be a good indication for phonomicrosurgery.

著者

米川 紘子 安達 薫 太田 文彦

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.139-145, 1989-12-01 (Released:2012-09-24)

参考文献数

16

被引用文献数

1

---

A total of 300 patients, 167 males and 133 females, with recurrent laryngeal nerve paralysis examined at the Department of Otolaryngology of Kinki University Hospital during the period from 1975 to 1988 were reviewed retrospectively. The results were as follows : (1) The age ranged from 40 to 79 years in 81 percent of the entire patients. (2) The incidence was higher for males than for females in the age group of 50 years and over. (3) The nerve was affected on the left in 187 (62.3%), on the right in 98 (32.7%) and on both sides in 15 patients (5.0%). (4) The paralysis was post-surgical in 125 patients and non-surgical in 175. The cause of paralysis was chest disease in 67, idiopathic in 48, neck disease (thyroid cancer in the majority) in 45, thyroid surgery in 40, chest surgery in 39 and endotracheal intubation in 36 patients. Chest diseases and surgeries were more frequent in males than in females whereas neck disease and thyroid surgeries were more frequent in females. (5) In 87 patients, paralysis resulted from malignant neoplasms. Forty-six of the 87 patients developed malignancies in the thorax. (6) The initial symptom of eight lung cancer, one mediastinal neoplasm, one esophageal cancer and three aneurysm cases was hoarseness. (7) Chest X-ray, CT and MRI and fluoroscopy of the esophagus were useful in detecting intrathoracic pathologies.

著者

片田 彰博

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.101-106, 2006-12-01 (Released:2012-09-24)

参考文献数

15

被引用文献数

1 1

著者

金子 真美 杉山 庸一郎 平野 滋

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.52-57, 2020-06-01 (Released:2020-09-04)

参考文献数

20

---

Medialization procedures, such as type I thyroplasty, arytenoid adduction, and vocal fold injection, are currently popular treatments for hoarseness due to unilateral vocal fold paralysis. However, hoarseness occasionally remains after medialization procedures due to tension imbalance. This tension imbalance causes diplophonia, asymmetry and aperiodic vibrational flutter in travelling wave motion. This is mostly due to incomplete glottic closure, imbalance in muscular tension, and increased air flow through an incompetent glottis. There is no established treatment for tension imbalance. We herein report two cases with remaining hoarseness post-medialization for chronic unilateral vocal fold paralysis. These patients underwent voice therapy using flow phonation to establish respiratory support and a resonant voice to facilitate vocal fold vibration. As a result, the functional vocal fold vibration, aerodynamic assessments, acoustic analysis findings and self-rated condition improved in both cases after therapy. These results suggest that voice therapy involving flow phonation and resonant voice may help improve the vocal function in cases of tension imbalance with dysphonia. Further studies with a larger number of participants or a prospective randomized controlled trial are warranted.

著者

竹山 勇 漆畑 保 堤 康一朗

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.5, no.1, pp.6-11, 1993-06-01 (Released:2012-09-24)

参考文献数

14

---

A marked difference in the incidence of laryngeal carcinoma between male and female has been widely unknown. The reason to this, however, has been unknown. In this connection, the affinity of the laryngeal tissue for androgen hormone was investigated in the present study. An auto radio-graphic study was conducted with the tissue of normal laryngeal mucosa and that of moderately differentiated squamous cell carcinoma of the larynx. 3H-T and its metabolites were found in the nuclei of epithelial cells of male vocal folds and some parts of male laryngeal carcinoma tissues. This suggest the existence of some effect of testosterone on the cell nuclei of these tissues. Quantitative analyses of the intracellular distribution of radioactivity conducted by means of the silver grain counting method showed that approximately 60-70% of 3H-T were located in the nuclear compartment of cancer cells of small size and the epithelium of the vocal fold near the basement membrane. The ABC method demonstrated a positive reaction in the nuclei of laryngeal carcinoma cells and the laryngeal muscle in males.These findings suggest that human laryngeal tissue, especially the vocal fold tissue, and laryngeal carcinoma cells may be one of the target organs for androgenic steroids and that androgen plays an important role in the carcinogenetic process of normal laryngeal tissue.

著者

渡嘉敷 亮二 平松 宏之

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.31, no.02, pp.129-136, 2019-12-01 (Released:2020-05-20)

参考文献数

21

---

Understanding the three-dimensional (3D) movement of immobile vocal folds (VFs) is very important. Because endoscopic findings reflect only the two-dimensional movement of VFs, it is impossible to obtain a correct diagnosis. The cases presented in this article include not only those of unilateral vocal fold paralysis (UVFP) but also arytenoid dislocation, laryngeal scarring and other statuses. The main diseases are described below.UVFP : Even in cases of light UVFP, the paralyzed arytenoid is passively displaced cranially during phonation. Some surgical procedures may be applied to manage UVFP, but only arytenoid adduction can resolve this passive movement. I will also describe several specific types of UVFP, such as adductor branch paralysis (AdBP).Arytenoid dislocation (AD) : AD can be divided into two types: posterior and anterior dislocation. Our 3D computed tomography (CT) study revealed that posterior AD is very rare and often misdiagnosed as AdBP (and vice versa). We detected two subtypes of anterior AD: cranial and caudal. The VFs in cases of caudal AD are located in the mid position, and the patient’s voice is not severely affected; as such, these cases are sometimes misdiagnosed as medial UVFP.Other types of immobile VF : A number of rare and unique types of immobile VF have been reported, such as scarring after intubation or trauma, fracture, congenital and VF of many other causes. Endoscopy is insufficient for understanding what happens to a patient’s immobile VF However, 3DCT can reveal the actual status of these cases.

著者

岡田 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.13, no.1, pp.23-26, 2001-06-01 (Released:2012-09-24)

参考文献数

16

---

Three cases of laryngeal foreign bodies in infants were treated in our hospital over the past 10 years. Among them, a case of a 1-year-old boy was reported. His chief complaint was coughing after having eaten fish. Videolaryngoscopy revealed pieces of fish bones in his subglottic space. First we removed a part of the fish bones with forceps via a flexible fiberscope following placement of a laryngeal mask under general anesthesia. Because of edema in the larynx, we removed the bones piece by piece with forceps by way of a rigid ventilation bronchoscope.With infants it is difficult to diagnose a laryngeal foreign body especially in the subglottic space. Videolaryngoscopy is useful in such cases. Before removal of a laryngeal foreign body, careful observation is mandatory to avoid unnecessary damage to the trachea and the larynx. To inspect the larynx and the trachea, the flexible fiberscope is a choice instrument following placement of a laryngeal mask under general anesthesia.

著者

西山 耕一郎

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.2, pp.93-100, 2016-12-01 (Released:2017-06-13)

参考文献数

22

被引用文献数

1

---

Dysphagia has now become a common disease in Japan, and the presence of otolaryngologists is more significant in the dysphagia clinics. Impaired swallowing function can easily cause suffocation and aspiration pneumonia which can be induced by food, saliva and stomach acid. Patients with dementia could have a suffocation by filling up food in their mouth. Although the aspiration pneumonia in elderly patients is difficult to avoid, an oral diet can often be continued with appropriate treatment. Multidisciplinary team approach is necessary in the field of swallowing medicine, however the otolaryngologist can play a leading role in the team evaluating the swallowing function and treating the dysphagia and pneumonia.

著者

岩田 重信 岩田 義弘 大山 俊廣 門山 浩 斎藤 正治 高須 昭彦

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.10, no.1, pp.1-7, 1998-06-01 (Released:2012-09-24)

参考文献数

18

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The electroglottogram (EGG) has been used to obtain details of vocal fold vibration. Applications of the EGG, however, are limited in use for voice disorders since characteristics of EGG waveforms associated with vocal fold vibrations are still poorly understood. We analysed the EGG waveform characteristics to compare them with simultaneous measurements of supra and subglottic pressure in the normal male subject sustaining the vowel /a/ at constant pitch with different intensity levels. The results are : The periodicities of the consequent frequency are completely coincident among the EGG wave, supra and subglottic pressure waveforms at different intensity levels. With regard to the amplitude variations of the EGG waveform in the vocal cycle, the increasing amplitude corresponded with a rapid increase of subglottic pressure and a decrease of supraglottic pressure which is indicative of the closing phase of the vocal folds. The gradual fall of amplitude associated with the parting of the vocal folds corresponded with an increase of supraglottic pressure from negative values and maintenance of negative subglottic pressure. The negative flatter portion of EGG wave corresponding to the opened phase exhibited higher positive supra glottal pressure and lower pressure of the subglottic even at different sound pressure levels. When increasing the intensity during constant pitch phonation, the values of the contact quotient and contact speed index decreased, and the contact closing slope became steeper.These findings reveal the tendency of increasing vocal tension following louder vocalization. Simultaneous measurement of EGG waveforms, and supraglottic and subglottic pressures might provide useful and detailed information for understanding EGG waveforms, laryngeal dysfunction and/or research for voice disorders.

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

---

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

---

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.