胸部悪性腫瘍の手術時に生じた反回神経麻痺に対する迷走神経―反回神経吻合術
肺癌5例と悪性胸膜中皮腫1例の根治術時に胸腔内迷走神経を切除したために反回神経麻痺が生じた．これによる主な症状は嗄声と発声時間の短縮，誤嚥であり，退院後のQOLを低下させる大きな要因である．我々はこれに対して，胸部の術後2から5ヵ月後に頚部の反回神経と迷走神経を直接吻合する迷走神経―反回神経吻合を行った．悪性胸膜中皮腫の再発1例を除く5例で神経吻合後3から6ヵ月で発声の回復，誤嚥が軽快した．...
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| Published in | 日本呼吸器外科学会雑誌 Vol. 27; no. 5; pp. 542 - 546 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
特定非営利活動法人 日本呼吸器外科学会
2013
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0919-0945 1881-4158 |
| DOI | 10.2995/jacsurg.27.542 |
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| Abstract | 肺癌5例と悪性胸膜中皮腫1例の根治術時に胸腔内迷走神経を切除したために反回神経麻痺が生じた．これによる主な症状は嗄声と発声時間の短縮，誤嚥であり，退院後のQOLを低下させる大きな要因である．我々はこれに対して，胸部の術後2から5ヵ月後に頚部の反回神経と迷走神経を直接吻合する迷走神経―反回神経吻合を行った．悪性胸膜中皮腫の再発1例を除く5例で神経吻合後3から6ヵ月で発声の回復，誤嚥が軽快した． |
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| AbstractList | 肺癌5例と悪性胸膜中皮腫1例の根治術時に胸腔内迷走神経を切除したために反回神経麻痺が生じた．これによる主な症状は嗄声と発声時間の短縮，誤嚥であり，退院後のQOLを低下させる大きな要因である．我々はこれに対して，胸部の術後2から5ヵ月後に頚部の反回神経と迷走神経を直接吻合する迷走神経―反回神経吻合を行った．悪性胸膜中皮腫の再発1例を除く5例で神経吻合後3から6ヵ月で発声の回復，誤嚥が軽快した． |
| Author | 池田, 直樹 原, 暁生 門田, 嘉久 松村, 晃秀 大倉, 英司 奥村, 明之進 福井, 絵里子 太田, 三徳 北原, 直人 |
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| References | 6. Miyauchi A, Matsusaka K, Kihara M, Matsuzuka F, Hirai K, Yokozawa T, et al. The role of ansa-to-recurrent-laryngeal nerve anastomosis in operations for thyroid cancer. Eur J Surg 1998; 164: 927-33. 2. Frazier CH, Mosser WB. Treatment of recurrent laryngeal nerve paralysis by nerve anastomosis. Surg Gynecol Obstet 1926; 43: 134-9. 3. Colledge L, Ballance C. The surgical treatment of paralysis of the vocal cord and of paralysis of the diaphragm. Br Med J 1927; 1: 553-9. 9. Filaire M, Mom T, Laurent S, Harouna Y, Naamee A, Vallet L, et al. Vocal cord dysfunction after left lung resection for cancer. Eur J Cardiothorac Surg 2001; 20: 705-11. 11. Miyauchi A, Inoue H, Tomoda C, Fukushima M, Kihara M, Higashiyama T, et al. Improvement in phonation after reconstruction of the recurrent laryngeal nerve in patients with thyroid cancer invading the nerve. Surgery 2009; 146: 1056-62. 5. Crumley RL, Izdebski K. Voice quality following laryngeal reinnervation by ansa hypoglossi transfer. Laryngoscope 1986; 96: 611-6. 4. Miyauchi A, Matsusaka K, Kawaguchi H, Nakamoto K, Maeda M. Ansa-recurrent nerve anastomosis for vocal cord paralysis due to mediastinal lesions. Ann Thorac Surg 1994; 57: 1020-1. 7. 日本内分泌外科学会, 日本甲状腺外科学会. 分化癌進行癌の外科治療 Cq46. 甲状腺腫瘍診療ガイドライン2010年版. 東京: 金原出版; 2010; 174-5. 8. Hirano M, Koike Y, von Leden H. Maximum phonation time and air usage during phonation. Clinical study. Folia Phoniatr (Basel) 1968; 20: 185-201. 1. Kraus DH, Ali MK, Ginsberg RJ, Hughes CJ, Orlikoff RF, Rusch VW, et al. Vocal cord medialization for unilateral paralysis associated with intrathoracic malignancies. J Thorac Cardiovasc Surg 1996; 111: 334-41. 10. Siribodhi C, Sundmaker W, Atkins JP, Bonner FJ. Electromyographic studies of laryngeal paralysis and regeneration of laryngeal motor nerves in dogs. Laryngoscope 1963; 73: 148-64. 12. Ohta M, Hirabayashi H, Shiono H, Minami M, Maeda H, Takano H, et al. Surgical resection for lung cancer with infiltration of the thoracic aorta. J Thorac Cardiovasc Surg 2005; 129: 804-8. |
| References_xml | – reference: 1. Kraus DH, Ali MK, Ginsberg RJ, Hughes CJ, Orlikoff RF, Rusch VW, et al. Vocal cord medialization for unilateral paralysis associated with intrathoracic malignancies. J Thorac Cardiovasc Surg 1996; 111: 334-41. – reference: 3. Colledge L, Ballance C. The surgical treatment of paralysis of the vocal cord and of paralysis of the diaphragm. Br Med J 1927; 1: 553-9. – reference: 6. Miyauchi A, Matsusaka K, Kihara M, Matsuzuka F, Hirai K, Yokozawa T, et al. The role of ansa-to-recurrent-laryngeal nerve anastomosis in operations for thyroid cancer. Eur J Surg 1998; 164: 927-33. – reference: 9. Filaire M, Mom T, Laurent S, Harouna Y, Naamee A, Vallet L, et al. Vocal cord dysfunction after left lung resection for cancer. Eur J Cardiothorac Surg 2001; 20: 705-11. – reference: 10. Siribodhi C, Sundmaker W, Atkins JP, Bonner FJ. Electromyographic studies of laryngeal paralysis and regeneration of laryngeal motor nerves in dogs. Laryngoscope 1963; 73: 148-64. – reference: 7. 日本内分泌外科学会, 日本甲状腺外科学会. 分化癌進行癌の外科治療 Cq46. 甲状腺腫瘍診療ガイドライン2010年版. 東京: 金原出版; 2010; 174-5. – reference: 8. Hirano M, Koike Y, von Leden H. Maximum phonation time and air usage during phonation. Clinical study. Folia Phoniatr (Basel) 1968; 20: 185-201. – reference: 2. Frazier CH, Mosser WB. Treatment of recurrent laryngeal nerve paralysis by nerve anastomosis. Surg Gynecol Obstet 1926; 43: 134-9. – reference: 5. Crumley RL, Izdebski K. Voice quality following laryngeal reinnervation by ansa hypoglossi transfer. Laryngoscope 1986; 96: 611-6. – reference: 12. Ohta M, Hirabayashi H, Shiono H, Minami M, Maeda H, Takano H, et al. Surgical resection for lung cancer with infiltration of the thoracic aorta. J Thorac Cardiovasc Surg 2005; 129: 804-8. – reference: 4. Miyauchi A, Matsusaka K, Kawaguchi H, Nakamoto K, Maeda M. Ansa-recurrent nerve anastomosis for vocal cord paralysis due to mediastinal lesions. Ann Thorac Surg 1994; 57: 1020-1. – reference: 11. Miyauchi A, Inoue H, Tomoda C, Fukushima M, Kihara M, Higashiyama T, et al. Improvement in phonation after reconstruction of the recurrent laryngeal nerve in patients with thyroid cancer invading the nerve. Surgery 2009; 146: 1056-62. |
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| SubjectTerms | 反回神経麻痺 嗄声 最大発声時間 誤嚥 |
| Title | 胸部悪性腫瘍の手術時に生じた反回神経麻痺に対する迷走神経―反回神経吻合術 |
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