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우리나라 이비인후과 외래환자의 인.후두 역류증상 발병빈도 조사(One Week Survey 결과)
최홍식,김형태,서장수,왕수건,조재식,최건,홍기환,김석일,이원철,Choi, Hong-Sik,Kim, Hyung-Tae,Seo, Jang-Soo,Wang, Soo-Gun,Cho, Jae-Sik,Choi, Gun,Hong, Ki-Hwan,Kim, Seok-Il,Lee, Won-Chul 대한후두음성언어의학회 2000 대한후두음성언어의학회지 Vol.11 No.1
1999년 4월 일주일간 전국 101개 병의원의 이비인후과 외래를 방문한 신환을 대상으로 설문을 실시하고 이비인후과 전문의의 진찰을 통하여 인.후두 위산역류중(LPR)의 발병빈도와 그와 관련된 사항들을 조사하여 다음과 같은 결과를 얻었다. 1) 이비인후과 신환 전체 진단 병명의 24%, 이비인후과 신환 환자 중 25%에서 LPR 관련 증상 또는 진찰소견이 확인되었다. 2) LPR 관련 진단명으로는 인두이물감증후군(Glo-bus syndrome)이 27%로 가장 많았으며, 역류성후두염, 만성후두염 등의 순이었다. 3) 여성에서 남성보다 많았으며, 40, 50, 60대에 흔하여 노인성 변화와의 관련이 의심되었다. 4) 비만도와는 큰 상관관계가 없었음. 5) LPR의 3대 주증상은 인두이물감, 만성적 목청소, 원인모를 쉰 목소리였음. 6) LPR을 악화시키는 요인으로는 피곤함, 정신적 스트레스, 술, 담배, 자극성있는 음식, 커피 등이었음. 7) 목소리를 직업적으로 쓰는 사람에서 LPR 증상의 발현이 높았음. 8) 과거 병력상 위질환과 잦은 편도염이 많았음. One week survey to investigate the prevalence rate and clinical characteristics of laryngopharyngeal reflux symptoms in Korea. The subject(n=7,704 patients) was newly enrolled patients at the out patient clinic in 90 ENT departments of resident training hospitals and 11 local clinics, which were voluntarily participated in the study 1) Twenty five percent of all enrolled patients has LPR-related symptoms or clinical findings from the examination by ENT specialists. 2) Among e name of LPR-related diagnosis, globus syndrome was e most common, and follows by reflux laryngitis, and chronic laryngitis. 3) Women was more prevalent than men, and it is common in 5th, 6th, and 7th decades, which seems to be related with aging process. 4) Most popular symtoms of LPR. were globus sensation, conic throat clearing, and hoarseness of unknown origin. 5) Aggravating factors of LPR-related symptoms were tiredness, mental stress, drink alcohol, cigarettes smoking, spicy food, and drinking coffee. 6) LPR-related symptoms were more common in professional voice users. 7) In past medical history, diseases of stomach and tonsillitis were most common.
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인후두 역류증에 대한 초치료로서 양성자 펌프 억제제4주 단기 치료의 효과
정만기,민진영,오재원,정한신,백정환,손영익 대한이비인후과학회 2005 대한이비인후과학회지 두경부외과학 Vol.48 No.6
Background and Objectives:Proton pump inhibitors (PPIs) can improve the symptoms of laryngopharyngeal reflux (LPR)if used for more than 8 weeks, but little information is available on the effects of short-term PPI therapy as an initial treatmentfor LPR. We aimed to evaluate the efficacy of 4-week short-term PPI medication as an initial treatment for LPR and to identifyspecific symptoms which can predict the outcome of treatment. Subjects and Method:Among the patients complaining ofmore than 3 typical LPR symptoms for over 3 months, 62 patients with LPR symptom scores over 8 points were enrolled for thestudy. The patients were randomly subjected either to the 4 weeks of prokinetics (n=31) or PPI (n=31) medication. Changesin subjective symptoms and objective findings were assessed at first visit and 4 weeks after the medication. Results:Treatmentwith prokinetics or PPI resulted in more than 50% reduction of LPR symptom scores in 9.6% or 29% of the patientsrespectively and 25-50% reduction in 54.8% or 70.9% of them. Objective reflux findings didn’t get improved in either group.Analyses of the obtained reflux symptom scores failed to predict the treatment outcome of PPI medication. Conclusion:ShorttermPPI therapy is highly effective for the reduction of LPR symptoms in selected patients, which may validate the use of PPIas an initial treatment regimen for the patients with LPR. However, further studies are required to assess the long-term effects of4-week PPI therapy as an initial treatment regimen.
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발성장애: 후두내시경 검사에서 놓치기 쉬운 성대점막질환
김한수,Kim, Han-Su 대한후두음성언어의학회 2010 대한후두음성언어의학회지 Vol.21 No.1
Dysphonia is a medical terminology for voice disorders characterized by hoarseness, harshness, weakness, or even loss of voice ; any impairment in ability to produce voice sounds using the vocal organs, larynx, The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc, The findings of laryngoscopy in these dysphonia are almost normal. Therefore, physicians should diagnosis these diseases from careful history taking and abundant understandings about the phonation pattern, Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold, Some lesions, however, are not easily found because these lesions are too small, or located on the lower lip of vibrating vocal fold. Laryngopharyngeal reflux induced laryngitis, vascular lesions, sulcus vocalis, vocal atropy including presbylaryngis, and mucosal tears are common lesions easily missed in laryngoscopy, Therefore, a high index of suspicion is necessary to avoid missing vocal fold mucosal lesions, and the strobovideolaryngoscopy is indispensable in making the diagnosis,
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