• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.2
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• pp.145-151
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• 2001

Background and Objectives : A voice therapy can be used the basic method for the voice improvement of patients with the voice disorders. However, according to each voice disorders, various results of treatments have been reported. The purpose of this study was to evaluate the clinical features of the patients who did not improved after the voice therapy and to explore factors that could affect the results of the voice therapy. Material and Method : There are patients (n=49) diagnosed as the vocal nodule and patients (n=13) diagnosed as the vocal polyp. They received the voice therapy more than 6 times from September, 2000 to August, 2001. Clinical features, stroboscopic findings, esophagographic findings and PNS x-ray findings were compared between the improved and the nonimproved groups. Results : Before the voice therapy, PNS x-ray found two of all patients had the paranasal sinusitis. 14 of the vocal nodule patients (28.6%) and 8 of the vocal polyp (61.5%) had GERD in the esophagogram. However, the recovery rate after the voice therapy had no significant difference in both the vocal nodule and vocal polyp with GERD. In patients with the vocal nodule, 47 of 49 (95.9%) improved after the voice therapy. 6 of them were found the clearly decreased lesion in the stroboscopy. But, in patients with the vocal polyp, 7 of 13 (53.8%) improved after the voice therapy and did not have improvement through the stroboscopy. Conclusion : If the treatment of GERD is given with the voice therapy after the evaluation of GERD, it is helpful to increase the effects of the voice therapy. And, if patients were improved partially or unimproved after voice therapy, it was important to evaluate all factors-motivation, compliance and cooperation-related with patients will. Through this, some factors might be minimized except diseases differences.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.2
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• pp.118-121
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• 2004

배경 및 목적 : 한국 구개열환자에게는 된소리 자음(농음0의 구음산출의 난도가 높다는 것은 임상적으로 잘 알려져 있다. 그러므로 본 연구에서는 한국 구개열 환자에게 있어서 난도가 높은 농음의 산출 메커니즘의 기본적 요소를 규명하므로서 언어치료의 새로운 방법모색에 기여하고져 하였다. 연구방법; 비강자음에 후속된 3종의 어두 파열자음 산출시의 구개범거근의 근활동 양상의 차이를 비교검토하므로서 농음의 산출특성을 검색하고져 하였다. 관찰기록 방법은 근전도는 유구침금전극(hooked wire electrodes)을 구강내로부터 경점막적으로 유도하였다. 연구결과 : 격음과 농음의 파열자음에서 평음보다 높은 구개범거근의 근활동이 관찰되었으나 격음과 농음 사이에선 유의미적인 차이는 보이지 않았다. 결 론 : 금후의 과제로는 피험자를 늘려 재확인을 하는 일, 및 농음과 격음의 변별요소에 관해 더욱 검토할 필요가 있는 것이 시사되었다.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.2
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• pp.112-117
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• 2004

Background and Objectives : This study is purposed to investigate the statistically significant discrimination model for predicting vocal fold nodule and polyp's lesional grade, with patients' background data and objective voice evaluation parameters. Materials and Method : The retrospective research was carried out at the Ewha Womans University Hospital. 122 patients' voice examination data had been selected, and lesion screening (Grade I, II, and III) was conducted by 2 ENT specialists, with each patient's vocal fold pictures achieved during the laryngoscopy examination. Results : The Lesional Grade Discrimination Model with which the lesional grade of vocal fold nodules and polyps could be predicted was derived by the ordinal logistic regression analysis (using SPSS 10.0). With this model the lesional grades of 73 out of 122 patients(59.8%) were correctly predicted to their formerly screened ones. Conclusion : This model applied the multivariate approach, which statistically combined these currently used parameters, Jitter, Shimmer, MFR, MPT, and patient's background data such as gender and dysphonia period. It might explain the status of benign lesion of vocal folds, and furthermore expect the physiological function of vocal folds.

• Speech Sciences
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• v.15 no.3
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• pp.159-173
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• 2008

The purpose of this study was to use fiber-optic nasolaryngoscope to find out differences in laryngeal behavior between persons who stutter(PS) and those who do not stutter(NS) upon their utterance. To meet the goal above, this study took 5 NS and 5 PS respectively as a part of sampling, so that they were all asked to join an experiment hereof. As a result, this study came to the following findings: First, there was not any significant difference in laryngeal behavior of uttering spoken languages between stuttering group and control. Second, there were some differences in laryngeal behavior of repetition and prolongation, which were a sort of disfluency revealed in the utterance of nonfluent spoken languages between stuttering group and control. Third, as reported by prior studies, it was found that there were differences in laryngeal abehavior of stutterer group's nonfluent spoken languages depending upon stuttering types. In this study, a variety of laryngeal behavior unreported in prior studies could be found. In addition, it was notable that stutterers showed different laryngeal behavior depending on their personal stuttering types. On block condition, Subject 1 showed laryngeal behavior of fAB, INT and fAD; Subject 2 showed laryngeal behavior of fAB, fAD and rAD; Subject 3 showed laryngeal behavior of fAD and rAD; Subject 4 showed only laryngeal behavior of fAD; and Subejct 5 showed laryngeal behavior of fAB, fAD and rAD. Summing up, these findings imply that when stutterers utter nonfluent words, they may reveal a variety of laryngeal behavior depending on their personal stuttering types. Moreover, it is found that there are more or less differences in the utterance of nonfluent spoken languages between NS and stuttering ones. In particular, it is interesting that one common trait of nonfluent spoken languages uttered by PS is evidently excessive laryngeal stress, no matter which type of stuttering they reveal.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.2
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• pp.199-203
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• 1997

In the treatment of spasmodic dysphonia, local injection of botulinum toxin A has been reported to be successful. The treatment of adductor type spasmodic dysphonia with botulinum toxin type A injection using a flexible nasopharyngoscope was conducted in 29 patients and using a telearyngoscope in 31 patients. These patients were given toxins in the vocal fold(s), unilaterally or bilaterally, under flexible nasopharyngoscopic guidance with sclerosing needle or telelaryngoscopic guidance with 23 gauge scalp needle attached by laryngeal forceps. Before the above procedure, laryngeal anesthesia was done with 2% pontocain instillation. Among the 60 patients, 59 patients were given the toxin successfully. Telephone interview were made at 2weeks and then at 4 weeks post injection. Among 29 patients using a flexible nasopharyngoscope, 75.8% and among 31 patients using a telelaryngoscope, 90.0% reported that the patients' symptom was improved. The functional status of the patient's disorder was classified into four grades. The mean pre-injection grade fir the patients using flexible nasopharyngoscope and telelaryngoscope was 1.6 and 2.1 respectively. And it was lowered to 0.7 and 1.1 respectively after the injection. The result was similar(p<0.05). As a self assessment method, the patients were asked to rate their voice on a scale of 100. In this study, the mean pre-injection score was 44 and 40 respectively. And it was improved to 77.7 and 69.8 respectively after the injection. The result was similar(p<0.05). In conclusion, botulinum toxin injection using a flexible nasopharyngoscope is also an effective method for the treatment of adductor type spasmodic dysphonia as using a telelaryngoscope.

• The Korean Journal of Emergency Medical Services
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• v.14 no.1
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• pp.5-18
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• 2010

Objective : This study compares Video laryngoscope and Direct laryngoscope in tracheal Intubation on rapidity and accuracy by paramedic and aims to improve efficiency of airway management and survival rate in pre-hospital treatment for the patients with severe trauma, cardiac arrest or dyspnea caused by acute diseases. Methods : 60 paramedics were recruited from 13 fire stations located in C province. With the consent of the paramedics, likelihood ratio test was carried out and they were divided into two different groups; DL group (30) and GVL group (30). Regarding intubation conditions, difficult airway grade I, grade II and grade III as well as sniffing position and neutral position were examined. This study also compared between ambulance in motion and in stand still. Frequency, average and standard deviation were analyzed with statistics program, SPSS WIN 17.0 and repeated measure design was introduced to examine inter-relations between position, grade and groups. Results : Intubation was performed more rapidly in neutral position and GVL than in sniffing position and DL(F = 15.260, p = .000). Rapidity value was better with grade I and grade II than grade III and better with GVL than DL(F = 32.629, p = .000). Accuracy value was higher with neutral position and GVL than sniffing position and DL(F = 5.008, p = .011). grade III was less accurate than grade I, grade II and GVL was more accurate than DL(F = 10.966, p = .000). Ambulance motion status did not show any statistically significant differences in accuracy and rapidity. Conclusion : Given this study results, neutral position is better for the patient with severe trauma. For a better survival, GVL intubation can be considered since GVL can enhance accuracy as well as rapidity regarding difficult airway. Since there is no significant differences in ambulance motion factors, intubation can be recommended even in moving ambulance for shortening traveling time to a hospital.

• International journal of thyroidology
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• v.11 no.2
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• pp.109-116
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• 2018

It is very important to identify recurrent laryngeal nerve (RLN) and prevent RLN injury during thyroid surgery. The intraoperative neuromonitoring (IONM) for the prevention of RLN injury is a useful method because it can identify the location and status of RLN and predict postoperative vocal cord function easily. The IONM consists of a stimulating side that applies electrical stimulation to the nerve and a recording side that measures the surface electromyography (EMG) of the vocal cord muscle through electrode endotracheal tube. The nerve stimulator and surgical dissector are separate instruments. So, during IONM for the prevention of the RLN injury in conventional, endoscopic, or robotic thyroid surgery, repeated exchanging between surgical instruments and the nerve stimulator is inconvenient and time consuming. On the recording side, the accuracy of the electrode endotracheal tube which measures the EMG of the vocalis muscle can be affected by contact with between electrode and vocal fold and position change of patient. We would like to introduce recent several researches to overcome the current limitations of IONM.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.11.2-11
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• 1983

Vocal nodules and polyps are much more frequent in singers, public speakers, teachers and actors. Voice trauma and voice misuse, at times associated with mild inflammatory reaction, appear to be important in their etiology. It is generally agreed that vocal cord nodules and polyps are inflammatory in nature and they arise in the subepithelial layer of loose connective tissue of the vocal cord. Since the junction of anterior and middle thirds of the membranous cord and has the greatest amplitude of vibration. This is the site of predilection for vocal cord nodules. The author performed laryngomicrosurgery for 70 cases of vocal nodules and polyps at Ewha Womans University Hospital during the period of 5 years. The result obtained were as follows ; 1) Surgical excision is not necessarily the best approach because vocal nodules in the early stages will resolve with the simplest voice therapy. 2) In children, surgery is rarely indicated because most nodules in children regress during adolescence. 3) For patients who use their voices professionally, voice therapy is indicated for three months. 4) If after three month of conservative treatment the cord lesion does not improve and the patient it still dissatisfied with his voice, laryngomicrosurgery can then be considered. 5) The small cuffed endotracheal tube in the interarytenoid space helps to keep the cords immobile and in an abducted position. 6) Removal of the nodule shoule be started by gentle retraction posteriorly and as soon as a tear appears anterior to the nodule. 7) On occasion it is preferable to start the dissection with a siccle knife while the nodule is held on the stretch. 8) Voice rest should be maintained for a week following which the free edges of the cords are usually healed.

• Clinical Pain
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• v.18 no.1
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• pp.24-30
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• 2019

Objective: Greater occipital nerve block (GONB) is a widely accepted treatment of primary headaches. Two ultrasound (US)-guided blockade techniques exist: 1) the classical distal nerve block technique performed medial to the occipital artery at the superior nuchal line, and 2) the new proximal nerve block technique performed at the obliquus capitis inferior muscle at the level of C2. Our study aim was to perform a head-to-head comparative study of these two US-guided techniques. Method: Forty-nine patients with primary headache treated in our university hospital were recruited. Patients were randomized into two groups of the classical nerve block and the new proximal nerve block techniques. The headache questionnaire was made to assess the intensity of the pain of headache attacks, number of days they experience headache, duration of headache, and amount of pain medication they consumed. Results: In both groups, a decrease in the severity and frequency of the headache was observed. There was no measurable difference in outcome between the two groups. Conclusion: Our study showed that the classic and new proximal techniques are equally effective in decreasing the headache severity and frequency.

• Journal of Chest Surgery
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• v.31 no.8
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• pp.799-803
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• 1998

Background: Tumors of the trachea are rare despite their histologic similarity to tumors of the main stem bronchus and lung. Materials and methods: Fourteen patients with tracheal tumor underwent surgical, radiational, or laser photocoagulation therapy from March 1981 to July 1996. Nine patients were malignant and five patients were benign. The most common malignant tumor was adenoid cystic carcinoma. Results: Age ranged from 10 to 65 years with mean age of 45.9 years. Most tumors were located middle and lower one-third of trachea. Surgery was done through collar incision, or collar incision with vertical partial sternal division, or left posterolateral thoracotomy, or sternal division with laryngeal release. Two patients died after operation, because of the disruption of anastomosis and airway obstruction,and laryngeal edema after suprahyoid release. Only one patient died after 8 month of diagnosis. The other patients were doing well during the follow-up period.