Management of vocal fold lesions in difficult laryngeal exposure patients in phonomicrosurgery.
スポンサーリンク
概要
- 論文の詳細を見る
[Objectives]Endolaryngeal microsurgery using a direct laryngoscope is a well-established procedure in phonosurgery. Adequate laryngeal exposure is essential, but in some cases sufficient view of the glottis cannot be obtained, leading to treatment failure. This study reports how to manage vocal fold lesions in difficult laryngeal exposure (DLE) cases. [Methods]From 2003 to 2009, 212 patients underwent endolaryngeal microsurgery at Kyoto Medical Center and Kyoto University Hospital. Phonomicrosurgery was performed under sniffing (Boyce–Jackson) position with triangular shaped laryngoscope for laryngeal exposure. However, in DLE cases, the posture and laryngoscope were modified as needed to adequately expose the lesion. Fiberoptic laryngeal surgery (FLS) with local anesthesia was also used for the most difficult cases. [Results]The number of the patients with DLE was 14 (6.6%). Endolaryngeal microsurgery was possible in DLE cases by selecting the appropriate posture and laryngoscope. However, the procedure could not be completed in two patients with an anterior web and a vocal fold cyst, both of which required a subsequent revision procedure. Fiberoptic laryngeal surgery with topical anesthesia was a feasible alternative for these cases. [Conclusions]Phonosurgery was possible even in DLE cases. It is important to modify the setup of direct laryngoscopy as needed to obtain adequate exposure. Fiberoptic surgery may also be used in certain difficult cases.
論文 | ランダム
- 電気自動車の開発動向 (新年号特集 低公害自動車の開発動向)
- 電気自動車の開発及び普及の現状と課題 (特集・自動車と環境問題)
- 電気自動車の最近の開発動向について
- 電気自動車の最近の動向 (特集:21世紀の自動車の安全と環境対応)
- BIOSYNTHESIS OF GPI ANCHOR : TOPICS FROM MA MMALIAN AND YEAST SYSTEMS