• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.74-74
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• 1993

다양한 원인에 의하여 야기되는 편측성대마비에 의한 애성을 치료하기 위하여 현재 사용되고 있는 방법으로는 테프론이나 실리콘 등의 성대내 주입술, 갑상연골성형술 등이 있다. 그러나 성대부전이 너무 크거나, 양측성대의 위상차이가 심한 경우에는 상기 수술법으로는 만족스러운 결과를 얻기가 용이하지 않다. 이런 경우에 피열연골의 근돌기를 외과적으로 노출시킨 후 측전방으로 당겨줌으로써 성대의 내전을 유도할 수 있는 피열연골내전술(arytenoid adduction)로 음성개선을 도모할 수 있다. 최근 저자들은 애성을 주소로 영동세브란스병원 이비인후과로 내원하였던 편측성대마비 환자 3예에서 보다 만족할만한 음성개선의 결과를 도모하고자 피열연골내전술을 시행하여 좋은 결과를 얻었기에 보고하는 바이다.

• 대한후두음성언어의학회지
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• 제22권1호
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• pp.18-22
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• 2011

Laryngeal framework surgery comprises medialization laryngoplasty and arytenoid adduction. Since their introduction in the 1970s, these procedures have become standard treatments for vocal fold paralysis and glottal incompetence. However, frequency of laryngeal framework surgery is conjectured to relatively decrease along with the introduction of injection laryngoplasty. In this manuscript, indications for laryngeal framework surgery were highlighted in contrast to those of injection laryngoplasty. The authors introduced the basic concepts and principles as well as surgical techniques of laryngeal framework surgery. Even though the incidence of major and/or minor complications after laryngeal framework surgery is not high, surgeons should be well aware of its possible complications and they should be familiar with tips and know-how to avoid or cope with complications.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 1999년도 제12회 학술대회
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• pp.175-175
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• 1999

배경 및 목적 : 성대마비환자에서 마비된 성대의 기능회복을 위해 여러 가지 방법으로 신경재지배를 시도하였으나 대부분이 misdirected reinnervation에 의한 후두의 synkinesis로 임상적으로 널리 이용되지 못하고 아직까지는 성대내전술등으로 음성의 질을 개선시키는 정도로만 치료하고 있는 실정이다 최근 복원에서는 반회후두신경의 절단 후 일차봉합에 의한 신경 재지배 후 후윤상피열근에 만성전기자극을 주었으나 자극을 주지 않은 대조군에 비해 후두기능회복이 더 잘된다는 결과를 확인하지 못한바 있다. 1980년대부터 pulsed electromagnetic fields (PEMFs)가 조직내에 ionic currents를 유도하여 cellular functions을 변화시킨다는 것을 보고된 이래로 PEMFs는 골절의 불유합이 있는 환자들에게 임상적으로 이용되고 있으며 최근 동물실험에서 흰쥐의 절단된 sciati nerve, common peroneal nerve, facial nerve의 신경재생을 촉진시켜 신경 재생이 조기에 되고 기능적으로 더 잘 회복되는 것으로 보고 있다. 이에 본 연구에서는 신경재생이 되더라도 기능적 회복이 힘든 것으로 알려진 반회후두신경의 재생 및 후두기능 회복에 대한 PEMFs의 영향을 알아보고자 하였다. (중략)

• 대한후두음성언어의학회지
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• 제7권1호
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• pp.5-10
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• 1996

From October 1991 to June 1995, 4 medialization thyroplasties and I arytenoid adduction were simultaneously performed with the thyroid surgery when the unilateral recurrent laryngeal nerve was paralyzed before or during thyroidectomy. Four cases were papillary carcinoma with direct invasion to the unilateral recurrent laryngeal nerve, and one case was huge adenomatous goiter and the recurrent laryngeal nerve was incidentaly cut. Hoarseness was present preoperatively with mean duration of 15 months and aspiration was also present in three cases. After phonosurgery, voice was improved in 4 out of 5 cases and aspiration subsided in 2 out of 3 cases. In one case, hoarseness continued after total thyroidectomy and thyroplasty type I and the arytenoid adduction with planned due to posterior glottic gap of 2mm. We suggest that the thyroplasty type I or arytenoid adduction are primary phonosurgical procedures which ran be performed concomitantly with neck surgeries in the patients with paralysis of the unilateral recurrent laryngeal or vagus nerve damage during neck surgeries.

• 대한후두음성언어의학회지
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• 제15권1호
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• pp.16-20
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• 2004

Purpose : To assess perceptual, acoustic and aerodynamic measure of voice quality in patients with unilateral vocal cord paralysis before and after type I thyroplasty. Methods : The clinical records of patients operated type I thyroplasty in the Departement of otorhinoalryngolgy, Yongdong Severance hospital from November 2001 to November 2003 were reviewed. All patients uderwent a vocal function evaluation including perceptual, acoustic and aerodynamic measures of voice preoperative and on $60^{th}$ postoperative day. The perceptual and acoustic measures were obtained from recording of patients' reading a 'Sanchak' passage. The perceptual evaluation was performed by 2 speech pathologist using a 4-point rating scale. Acoustic parameters(voice range profile low(RAL), voice range profile high(RAH), average fundamental frequency(AFX), closed quotient, harmonic to noise ratio, jitter and shimmer) were investigated by Lx speech studio. Mean flow rate(MFR), subglottic pressure(Psub) and intensity were measured using the Phonatory function analyzer. The maximum phonation time was also measured. The data were statistically analyzed. A paired t-test (p<0.1) was used to compare preoperative and postoperative results. And multiple regression test was used to find which parameter was most correlated to improvement of postoperative voice quality. Results : Among aerodynamic parameters, Psub $(88.11mmH_2O{\rightarrow}58.7mmH_2O)$, MPT(7.87sec${\rightarrow}$12.53sec), MFR (359.8ml/sec${\rightarrow}$161.06ml/sec) were statistically improved. AFx(205.5Hz${\rightarrow}$163.27Hz), AQx(23.9%${\rightarrow}$48.3%), RAL, RAH. Jotter and shimmer were improved. In multiple regression test, AFx and AQx was noted as the two meost correlated parameters to improvement of postoperative breathiness. But general grade of voice quality was more correlated to Psub and shimmer. Conclusion : Vocal fold medialization procedures effectively reduce glottic gap. Increasing of contact area of both vocal folds induced improvement in aerodynamic parameters and leaded stabilizing of vocal fold vibration. That effect results in improvement in acoustic parameters (shimmer, jitter, signal-to-noise ratio, voice range profile) and voice quality.