著者

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.19, no.2, pp.87-92, 2007-12-01 (Released:2012-09-24)

参考文献数

17

被引用文献数

2 4

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Highpoints of laryngomicrosurgery are described in this paper as the following : 1. Align head position appropriately for ideal exposure of the glottis.The appropriate posture for direct laryngoscopy is the “Flexion-Extension” position. Suspension laryngoscopy and external counter pressure contribute to optimal exposure of the glottis.2. Selection of laryngoscope.Several types of laryngoscopes have been developed including round shaped, triangular shaped, retractable, etc. A posterior glottis laryngoscope was also developed for the management of posterior glottis lesions such as granulomas. It is important to have different types of laryngoscopes and to select the most appropriate one according to each lesion.3. Selection of instruments.There are several kinds of cold instruments as well as laser equipment. It is also important to use these instruments properly for each type of lesion.4. Surgical technique.Amputation or the micro-flap procedure should be selected for elevated lesions of the vocal fold on a case by case basis.

著者

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.16, no.2, pp.96-101, 2004-12-01 (Released:2012-09-24)

参考文献数

24

著者

兵頭 政光 相原 隆一 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.7, no.1, pp.64-70, 1995-06-01 (Released:2012-09-24)

参考文献数

14

被引用文献数

2 5

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The hypopharyngeal constrictor muscle consists of the thyropharyngeal (TP) and cricopharyngeal (CP) muscles. These two muscles cooperatively and, in a sense, competitively work at the pharyngeal swallowing stage. Contraction of the TP muscle drives bolus into the esophagus, while the CP muscle ralaxes and allows the bolus to pass through the upper esophageal sphincter which is made by a contraction of the CP muscle.We investigated histochemical properties of these two muscles. Acetylcholine esterase stain showed that the neuromuscular junctions of the CP muscle were scattered in the horizontal direction compaired to those of the TP muscle. Glycogen depletion test showed that the glycogen-negative muscle fibers were distributed uniformly througout the TP muscle, while those of the CP muscle decreased in number from the stimulated side toward the unstimulated side. These results suggested that the CP muscle fibers terminate in the belly of the muscle, and that length of the CP muscle fiber is not uniform. Actomyosin ATPase stain revealed that type 2B fiber was predominant in the TP muscle, while type 1 fiber was predominant in the CP muscle. The mean diameter of the TP muscle fibers was larger than that of the CP muscle.In conclusion, the histochemical properties of the TP and CP muscle showed a great contrast to each other. But these different properties gradually change around the border of the two muscles.

著者

千年 俊一

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.15, no.1, pp.11-18, 2003-06-01 (Released:2012-09-24)

参考文献数

15

被引用文献数

1 1

---

Development of the laryngeal mucosa and its relationship to the appearance of glandular distribution was studied by examining the changes in the laryngeal structures at the level of subglottic larynx of 55 human infants. By making a transverse section at the level of cricoid cartilage, the area and diameter of each subglottic structure were examined using an image analysis system. The results were analyzed not only by their age at birth, but also based on the Total Development Score (TDS) that was estimated by adding the age at death and the gestational period. The areas of the whole structure, cricoid ring, maximum airway, subglottic mucosa and inner cavity (available airway) increased in close correlation with the TDS. In contrast to the increased diameter of the inner cavity, the thickness of the mucosa was almost the same size. The area occupied by the glands increased according to TDS. These results indicate the stability of the subglottic airway with advancing age and, also, the local defense system by glandular tissues develops constantly after birth.

著者

藤田 真知子

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.115-121, 1989-12-01 (Released:2012-09-24)

参考文献数

19

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The fundamental frequency (F0) and sound pressure level (SPL) of voice were measured in 1,563 dysphonia patients of varying etiologic diseases. The measured values were compared with the values obtained from normal control subjects. The results were summarized as follows : (1) In most disease groups, the highest F0 was low and the F0 range was decreased. (2) In most disease groups, the SPL for the loudest phonation was reduced and the SPL range was small. (3) The F0 level for habitual phonation was low in acute laryngitis and Reinke's edema and it was high in sulcus vocalis, carcinoma and mutational dysphonia in males, whereas, in females, the F0 level for habitual phonation was low in many disease groups. (4) Similar tendencies were noted with the lowest F0. (5) The SPL for habitual phonation was within the normal range in almost all disease groups. (6) F0 and SPL presented low but significant correlation to the degree of the lesion in the cases with polyp and carcinoma. (7) The effect of treatment was reflected on F0 and/or SPL in many disease groups.

著者

喜友名 朝則 真栄田 裕行 比嘉 麻乃 鈴木 幹男

出版者

日本喉頭科学会

雑誌

喉頭 = The Larynx Japan (ISSN:09156127)

巻号頁・発行日

vol.24, no.1, pp.1-5, 2012-06-01

参考文献数

15

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Objective : The aim of the present study is to clarify central phonation control during high pitch vocalization.<BR>Subjects and methods : The participants were 16 right-handed, healthy adults. Functional magnetic resonance imaging (fMRI) was employed to detect brain activity in response to vowel phonation (&frasl;i:&frasl;) with high pitch. The sparse sampling method for MRI scanning was used to reduce body movement artifacts due to phonation and acoustic artifacts due to scanner noise. The brain activity in response to phonation with comfortable pitch as well as high pitch was measured using the statistic parametric mapping 5 software.<BR>Result : Brain activation specific to high pitch phonation was observed in the anterior cingulate cortex and cerebellum. There was however no specific motor cortex activity during high pitch phonation.<BR>Conclusion : In the central phonation control system proposed by Symonyan et al, subsystem II (periaqueductal gray matter, anterior cingulate cortex, and limbic input structures) is involved in regulating vowel phonation with high pitch.

著者

二藤 隆春 木村 美和子 田山 二朗

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.101-105, 2007-12-01 (Released:2012-09-24)

参考文献数

11

被引用文献数

1

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.