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Volume 62, Issue 1
Displaying 1-9 of 9 articles from this issue
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Original
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Kazuhiro Nakamura, Kiyoaki Tsukahara, Tomoyuki Yoshida, Taro Inagaki, ...2011 Volume 62 Issue 1 Pages 1-10
Published: February 10, 2011
Released on J-STAGE: February 25, 2011
JOURNAL RESTRICTED ACCESSDyspnea due to laryngeal edema is a well-known postoperative complication of arytenoid adduction (AA). Other complications that may be encountered include hematoma, infection, tracheal perforation, and esophageal perforation. We examined the postoperative complications of AA performed in our department.
A total of 28 patients underwent AA at our institution between September 2001 and January 2010. Five patients (17.9%) developed complications. These included dyspnea in three cases (10.7%), postoperative hemorrhage in two cases (7.1%), esophageal perforation in two cases (7.1%), and infection/abscess in three cases (10.7%). Tracheostomy was necessitated in three patients (10.7%), and a Gore-Tex removal operation was needed in two patients (7.1%).
Laryngeal edema due to a bleeding hematoma in the acute phase necessitated use of quick hemostatic techniques and tracheostomy. When esophageal perforation was detected in the subacute phase, preventive tracheotomy and quick fistula reefing were performed. It is necessary to treat the piriform sinus mucosa carefully for prevention of esophageal perforation. In patients with infection/abscess in the late phase, we had to remove the Gore-Tex, which was a foreign body.View full abstractDownload PDF (4442K) -
Yoshitsugu Nimura, Masahiko Higashikawa, Terue Okamura, Ken Nakai, Ken ...2011 Volume 62 Issue 1 Pages 11-16
Published: February 10, 2011
Released on J-STAGE: February 25, 2011
JOURNAL RESTRICTED ACCESSFDG-PET is employed to decide the treatment strategy for malignant tumors clinically. Meanwhile, glucose metabolism is enhanced in the exercise of muscles. Because vocal folds always conduct glucose metabolism by phonation and swallowing, physiological accumulation of FDG may be found in the normal larynx. In this study we examined FDG accumulation in the larynx of patients with unilateral vocal fold paralysis established by endoscope. FDG-PET/CT was taken one hour after the FDG administration (early image) and again two hours later (delayed image). All patients had no chance to utter after the FDG administration. In 25 of the 28 patients with unilateral vocal fold paralysis, SUVmax was higher, by visual inspection, in the normal side of the larynx than in the paralyzed side. None of the 3 patients in whom no accumulation was seen on the non-paralyzed side had malignant disease. In both images, SUVmax of the normal side was significantly higher than paralyzed side (p<0.01). In the delayed images, accumulation of FDG was significantly higher than that in the early images (p<0.01). We believe that strong FDG accumulation in the normal side of the larynx of patients with unilateral vocal fold paralysis may owe to high glucose metabolism of the vocal muscles from muscle hyperkinesis. We conclude that unilateral accumulation in the larynx suggests not only cancer of that same side of the larynx but also paralysis of the other side.View full abstractDownload PDF (654K) -
Tomohiko Kakizaki, Takashi Tsubuku, Michiya Matsumura, Yasushi Furuta2011 Volume 62 Issue 1 Pages 17-23
Published: February 10, 2011
Released on J-STAGE: February 25, 2011
JOURNAL RESTRICTED ACCESSWe experienced six cases of laryngeal herpes zoster between July 2007 and March 2010. Anti-varicella zoster virus (VZV) antibodies were measured at the initial visit and two to three weeks later, and all six cases showed a significant increase in anti-VZV-IgG antibody values. All patients complained of pain such as sore throat or swallowing pain. Four patients had associated laryngeal paralysis and two had facial paralysis. Two patients with associated laryngeal paralysis showed no typical enanthems in the larynx or pharynx and were diagnosed as zoster sine herpete by virological assay. All patients were administered an anti-viral agent and steroid. Nerve disorders were completely recovered in four patients. In one patient, however, vocal cord paralysis was left at six months after onset. In cases of associated laryngeal paralysis with sore throat or swallowing pain, VZV infection should be considered as a differential diagnosis and early treatment with anti-viral agent and steroid should be performed. For a definitive diagnosis, anti-VZV antibodies should be measured using paired sera obtained at the initial visit and two to three weeks later.View full abstractDownload PDF (728K)
Case Report
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Takashi Kurita, Hirohito Umeno, Shunichi Chitose, Sachiyo Hamakawa, Ta ...2011 Volume 62 Issue 1 Pages 24-29
Published: February 10, 2011
Released on J-STAGE: February 25, 2011
JOURNAL RESTRICTED ACCESSLaryngoplasty is basically performed by monitoring the patient's phonation during surgery in a stage of alertness. Recently, however, the surgery is often performed under general anesthesia. We report a case of gender identity disorder (male to female) suffering from dyspnea, dysphasia and dysphonia after type IV thyroplasty performed under general anesthesia at another institute.
On examining the patient, we observed impaired abduction of the bilateral vocal folds and narrowing of the airway. The right vocal fold was fixed at median position, and the left vocal fold revealed abduction disorder. For improvement of dyspnea, we removed the nylon sutures from the type IV thyroplasty that had brought thyroid cartilage closely proximate to the cricoid cartilage, but we were unable to undo the approximation. We then performed tracheal fenestration for improvement of dyspnea. Movement of vocal folds was slightly improved one year after the tracheal fenestration, and dyspnea, dysphagia and dysphonia were also recovered.
In this case, we speculate that dysphonia and the occurred as a result of dysfunction of larynx elevation, which caused overextension of the vocal cords due to the excessive proximity between the thyroid cartilage and cricoid cartilage. Regarding the reason for the improvement in vocal fold movement, we conjecture that the tension of vocal folds from overextension over the long term decreased over time.View full abstractDownload PDF (3278K) -
Seiji Hosokawa, Jun Okamura, Yoshinori Takizawa, Hiroyuki Mineta2011 Volume 62 Issue 1 Pages 30-35
Published: February 10, 2011
Released on J-STAGE: February 25, 2011
JOURNAL RESTRICTED ACCESSAmyloidosis is a rare disease, especially cases originating in the larynx. We encountered two patients with amyloidosis in the larynx.
A 67-year-old woman was referred to our institute with a complaint of hoarseness. At the initial examination, a smooth-surface tumor was detected in the supraglottic region. We performed laryngomicrosurgery (LMS) and resected the tumor. Histopathological findings revealed amyloidosis. Systemic amyloidosis was excluded in follow-up examinations. The patient had relapsing lesions two times, at 2 and 11 years after initial treatment. We treated and removed the enlarged tumor by LMS using YAG laser. Eleven and a half years after LMS, she is in good condition. The other patient was a 71-year-old female who complained of hoarseness.
The patient had been diagnosed as laryngeal amyloidosis at another institute 16 years earlier. She was referred to our hospital because of tumor development, but she did not suffer symptons other than hoarseness and the airway was intact. The patient was informed of the diagnosis in detail, and simple observation was provided.
Recently, the main treatment of amyloidosis is limited surgical resection by LMS using laser. However, long-term follow-up is required because the disease can recur up to several years after treatment.View full abstractDownload PDF (2067K) -
Yuki Komabayashi, Akihiro Katayama, Kan Kishibe, Isamu Kunibe, Akihiro ...2011 Volume 62 Issue 1 Pages 36-42
Published: February 10, 2011
Released on J-STAGE: February 25, 2011
JOURNAL RESTRICTED ACCESSWe report a case of angioedema requiring emergent tracheostomy. A 62-year-old male was brought to the emergency room with swelling of the tongue and throat. His tongue and epiglottis were swollen severely without pain. Dyspnea developed acutely, so we attempted emergent tracheostomy in the emergency room. During the operation, he suffered respiratory arrest. In response we performed cricothyrotomy followed by tracheostomy. The patient had been taking angiotensin converting enzyme (ACE) inhibitor and angiotensin II receptor blocker (ARB) for hypertension. There has been no recurrence of symptoms after termination of the ACE inhibitor and ARB. It is known that angioedema is induced by ACE inhibitor, and recently there have been a few reports of angioedema associated with ARB. Because angioedema can have potentially fatal consequences, we should be aware of upper airway obstruction.View full abstractDownload PDF (2232K) -
Takuya Sato, Tsutomu Nakamura, Masaho Ota, Yuji Shirai, Masakazu Yamam ...2011 Volume 62 Issue 1 Pages 43-47
Published: February 10, 2011
Released on J-STAGE: February 25, 2011
JOURNAL RESTRICTED ACCESSA 39-year-old male presenting with epigastralgia was found in endoscopy to have a submucosal tumor about 19 cm from the incisor. EUS showed a low echoic area in the submucosal layer. MRI revealed a high-intensity lesion on both T1 and T2 weighed images. Based on a diagnosis of esophageal cyst (foregut cyst),we surgically resected the tumor using a left neck incision.
The resected specimen was a 30×20×18 mm unilocular and spindle-shaped cyst containing dark red liquid component. Microscopic findings of the resected specimen showed the cyst wall had become ciliated columnar epithelium without cartilage, bronchial gland or esophageal gland.View full abstractDownload PDF (2913K)
Glossary
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[in Japanese]2011 Volume 62 Issue 1 Pages 48-49
Published: February 10, 2011
Released on J-STAGE: February 25, 2011
JOURNAL RESTRICTED ACCESSDownload PDF (1643K) -
[in Japanese], [in Japanese]2011 Volume 62 Issue 1 Pages 50-52
Published: February 10, 2011
Released on J-STAGE: February 25, 2011
JOURNAL RESTRICTED ACCESSDownload PDF (212K)
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