Anesthesias for Phonosurgery
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概要
- 論文の詳細を見る
In this paper, several kinds of anesthesias are described from the viewpoint of application for phonosurgery. And their merits or demerits are discussed for the benefit of choosing one of anesthesic methods.<BR>Authors concluded as follows;<BR>1) Topical anesthesias should be used for correction or resection of simple laryngeal lesions like pedinculated polyp, and should be performed especially when easy exposure of the larynx is possible.<BR>2) Anesthesia of percutaneous jet ventilation is very useful for resection of lesions like granulomas which frequenently occurrs in posterior portion of the larynx. More precise surgery is necessary for laryngeal granulomas because of their common recurrence.<BR>As entire surgical field including posterior portion of the larynx cannot be obtained with a tracheal tube, jet anesthesia in which a tracheal tube is not necessary is the most suitable for laryngeal granulomas in the posteirior wall of the larynx.<BR>3) General anesthesia with an endotracheal tube is most commonly used for every part of surgery. Even for phonosurgery, this method is still useful for precise correction of the shape of the vocal cord. However, this method has tow demerits. First, observing of surgical field is not always complete because of the endotrachal tube itself. Second, the surgeon cannot hear the patient's voice while performing the operation.<BR>4) Neuroleptanalgesia (NLA) might play a very important role in phonosurgery. Phonosurgery is not only for cure of lesions but also for improving phonatory function. With NLA, the patient can phonate. Hence, the surgeon can hear the voice and observe the vibratory pattern of the vocal cord under stroboscopic light during the operation. The surgeon easily knows where in vocal cords and how surgical procedures should be carried out. However, every surgeon should recognize that more sophisticated technique is required when performing phonosurgical procedures under NLA.
- 日本音声言語医学会の論文
著者
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福田 宏之
慶応義塾大学医学部耳鼻咽喉科
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斎藤 成司
慶応義塾大学医学部耳鼻咽喉科
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小野 博
慶応義塾大学医学部耳鼻咽喉科学教室
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市川 忠
慶応義塾大学医学部耳鼻咽喉科
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牧野 克巳
慶応義塾大学医学部耳鼻咽喉科
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市川 忠
慶応義塾大学医学部耳鼻咽喉科学教室
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牧野 克巳
慶応義塾大学医学部耳鼻咽喉科学教室
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