KISEP Case Report 臨床耳鼻 : 第 15 卷第 2 號 2004 J Clinical Otolaryngol 2004;15: 후두경피증환자의수술적치료 2 예 중앙대학교의과대학이비인후과교실 김경수 서강욱 백상흠 양훈식 Two Cases of Surg

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1 KISEP Case Report 臨床耳鼻 : 第 15 卷第 2 號 2004 J Clinical Otolaryngol 2004;15: 후두경피증환자의수술적치료 2 예 중앙대학교의과대학이비인후과교실 김경수 서강욱 백상흠 양훈식 Two Cases of Surgical Management of Pachyderma Laryngis Kyung-Soo Kim, MD, Gang-Wook Seo, MD, Sang-Hum ak, MD and Hoon-Shik Yang, MD Department of Otorhinolaryngology-Head and Neck Surgery, Chung-ng University, College of Medicine, Seoul, Korea - STRCT - Laryngopharyngeal reflux LPR is somewhat different from classic gastroesophageal reflux disease in its patterns, mechanism, manifestations and so on. The chief complaints of LPR are known as sore throat, throat clearing, hoarseness and foreign body sensation, but heartburn is uncommon. Laryngeal manifestations of LPR are reported as globus pharyngeus, reflux laryngitis, pachyderma laryngis, contact granuloma or ulcer, laryngeal leukoplakia, Reinke s edema, posterior glottic stenosis, subglottic stenosis, laryngomalacia, vocal nodule or cyst, paroxysmal laryngospasm, malignancy, etc. Treatment for LPR includes changes of the diet pattern and lifestyle, and acid-suppresssing therapy Medication and ntireflux surgery. uthors report two cases of effective management of pachyderma laryngis with huge interarytenoid mass associated with LPR which was refractory to medical treatment. Surgical excision of the lesion was effective for resolving symptoms and shortened treatment period. (J Clinical Otolaryngol 2004;15: ) KEY WORDS:Laryngopharyngeal reflux Pachyderma laryngis Laryngoscopic surgery. 서 론 294

증례 1: 증례 Fig. 1. Preoperative photography shows.

lymphoplasmacytic infiltrations are noted in Case 1 Hematoxylin and

2 증례 1: 증례 Fig. 1. Preoperative photography shows. Huge, erythematous, ovoid shaped, mass-like lesion on interarytenoid fold in Case 1. Whitish and broad mass-like lesion on interarytenoid fold in Case 2. Fig. 2. Pathology. Mild acanthosis with parakeratosis, submucosal edema with lymphoplasmacytic infiltrations are noted in Case 1 Hematoxylin and Eosin stainoriginal magnification 100. Squamous epithelium with mild reactive change and lymphocytic infiltrations are noted in Case 2 Hematoxylin and Eosin stainoriginal magnification

J Clinical Otolaryngol 2004;15:294-298 Fig. 3.

3 J Clinical Otolaryngol 2004;15: Fig. 3. Postoperative laryngoscopic view 4 weeks. Interarytenoid fold is mild edematous, but much improved in Case 1. Interarytenoid fold is nearly normalized in Case 2. 증례 2: 고찰 296

4 - 중심단어 REFERENCES 1) Koufman J. The otolaryngologic manifestations of gastroesophageal reflux disease. clinical investigation of 225 patients using ambulatory 24-hour ph monitoring and an experimental investigation of the role of acid and pepsin in the development of laryngeal injury. Laryngoscope 1991;101: ) Koufman J. Laryngopharyngeal reflux is different from classic gastroesophageal reflux disease. Ear Nose Throat J 2002;81:7-9. 3) Noordzij JP, Khidr, Desper E, Meek R, Reibel JF, Levine P. Correlation of ph probe-measured laryngopharyngeal reflux with symptoms and signs of reflux laryngitis. Laryng- 297

5 J Clinical Otolaryngol 2004;15: scope 2002;112: ) Koufman J, Sataloff RT, Toohill R. Laryngopharyngeal reflux: Consensus Report. J Voice 1996;10: ) Close LG. Laryngopharyngeal manifestations of reflux: diagnosis and therapy. Eur J Gastroenterol Hepatol 2002; 14:S ) Peter C. elafsky PC, Postma GN, min MR, Koufman J. Symptoms and findings of laryngopharyngeal reflux. Ear Nose Throat J 2002;81: ) ough ID Jr, Sataloff RT, Castell DO. Gastroesophageal reflux laryngitis resistant to omeprazole therapy. J Voice 1995;9: ) Koufmann J. Gastroeophageal reflux and voice disorders. In: Rubin, editor. Diagnosis and treatment of voice disorders. 1st ed. New York, Tokyo: Igaku-Shoin; p ) Hanson DG, Kamel PL, Kahrilas PJ. Outcomes of antireflux therapy for the treatment of chronic laryngitis. nn Otol Rhinol Laryngol 1995;104: ) Metz DC, Childs ML, Ruiz C, Weinstein GS. Pilot study of the oral omeprazole test for reflux laryngitis. Otolaryngol Head & Neck Surg 1997;116: ) Rival R, Wong R, Mendelsohn M. Role of gastroesophageal reflux disease in patients with cervical symptoms. Otolaryngol Head & Neck Surg 1995;113: ) Jaroma M, Pakarinen L, Nuutinen J. Treatment of vocal cord granuloma. cta Otolaryngol 1989;107:

Fig. 1. Laryngoscopic findings according to Yonekawa Fig. 2. possible etiologic factors. 2A Smoking, 2B Gastroesophageal reflux symptom, 2C Skin

Fig. 1. Laryngoscopic findings according to Yonekawa Fig. 2. possible etiologic factors. 2A Smoking, 2B Gastroesophageal reflux symptom, 2C Skin KISEP Head and Neck Korean J Otolaryngol 2000;43:873-7 라인케부종의원인및음성학적고찰 안중호 남순열 Possible Etiology and Voice Analysis of Reinke s Edema Joong Ho Ahn, MD and Soon-Yuhl Nam, MD Department of Otolaryngology,

KISEP Case Report 臨床耳鼻 : 第 15 卷 第 2 號 2004 J Clinical Otolaryngol 2004;15: 후두경피증환자의수술적치료 2 예 중앙대학교의과대학이비인후과교실 김경수 서강욱 백상흠 양훈식 Two Cases of Surg

KISEP Case Report 臨床耳鼻 : 第 15 卷第 2 號 2004 J Clinical Otolaryngol 2004;15: 후두경피증환자의수술적치료 2 예 중앙대학교의과대학이비인후과교실 김경수 서강욱 백상흠 양훈식 Two Cases of Surg