• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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• pp.14.4-15
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• 1983

이비인후과영역의 악성종양중 가장 많은 빈도를 보이는 후두암의 외과적료법으로는 1873년 Billroth가 처음으로 후두전적출위을, 1873년 H. B. Sands가 후두부분절제술을 시행한 이래 항생제료법, 수혈 및 보다 안전해진 마취 등의 전반적인 진보로 수술후 보다 좋은 예후를 가져왔다. 후두의 임파계는 구획되어 있는 해부학적 특성이 있기 때문에 후두부분절제술의 시행을 가능케 하였으며 이러한 후두부분절제술은 후두전적출술에 비하여 적응증이 다르긴 하나 환부를 제거함과 동시에 발성작용, 호흡작용 및 방어작용등의 기능적인 면을 보존시킬 수 있는 장점이 있다. 최근 수술적요법은 화학요법, 방사선료법 등과 병합으로 재발의 빈도를 줄이고 5연생존율을 증가시켰다. 저자들은 1980연부터 1982연까지 고대부속병원 이비인후과에 내원한 후두암환자중 후두부분절제술의 적응이 되는 8예를 경험하였다. 이들의 발병부위는 후두개 2예, 양측성대 전 1/3부위 2예, 우측성대 전 1/3부위 및 전연합부 1예, 우측후두실 1예, 좌측성대 중 1/3부위 2예로서 이들에 시행한 후두부분절제술에 대하여 문헌적 고찰과함께 보고하는 바이다.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 1993년도 제1회 학술대회 연제순서 및 초록집
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• pp.20-20
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• 1993

저자들은 1983년 4월부터 1993년 9월까지 10년 6개월간 연세대학교 의과대학 영동세브란스병원 이비인후과에 내원한 종양에 의한 성대마비환자 29례에 대한 임상적 분석을 통하여 다음과 같은 결론을 얻었다. 1) 종양의 종류별로는 폐암이 13예(44.8％)로 가장 많았으며 갑상선암이 8예(27.6％), 신경성종양이 3예(10.4％), 종격동종양이 2예(6.9％), 그 외 경부식도암, 기관지암, 경정맥소체종양이 각각 1예로 나타났다. (중략)

• 대한두경부종양학회지
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• 제33권1호
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• pp.53-56
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• 2017

Pharyngocutaneous fistula is one of the most common wound complications after total laryngectomy. The leakage of saliva may cause an erosion of greater vessels nearby and result in a life-threatening bleeding. 65-year-old male received laryngectomy and pharyngectomy followed by Latissimus dorsi flap reconstruction due to recurred laryngeal cancer with oropharyngeal extension after postoperative radiotherapy. Pharyngeal fistula was developed and an excessive fresh blood flowed through the oral and nasal cavity. The patient was transferred to the operating room immediately, and the causing artery was ligated. The rupture of the common carotid artery and its branches should be warned when the pharyngocutaneous fistula is developed. Prompt and proper therapy must be performed for the patients with impending or acute hemorrhage.

• 대한후두음성언어의학회지
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• 제9권1호
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• pp.86-90
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• 1998

Verrucous carcinoma is a variant of highly differentiated squamous cell carcinoma and has a predilection for the oral cavity and larynx. It is known to be of good prognosis due to its low regional and distant metastatic potential. Peak incidence is at ages 40-69 while predominantly occuring in males and its association with tobacco smoking has been implicated. The verrucous carcinoma have accordingly been treated by radiotherapy or surgical procedures but there has been considerable controversy regarding the effect of radiotherapy due to the possibility of anaplastic transformation Laser surgery and partial resection are among the commonly used surgical procedures but laser surgery has not yet shown results in improving phonetic abilities. Authors experienced two cases of verrucous carcinoma of the larynx treated by partial laryngectomy and false vocal cord advancement flap who showed no recurrence of disease under stroboscopic examination after two year follow up and when compared to preoperative aerodynamic studies, the expiratory air pressure was decreased and mean air flow rate increased which improved glottal efficiency markedly.

• 대한후두음성언어의학회지
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• 제14권2호
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• pp.110-116
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• 2003

Background and Objectives : Laryngeal cancer discrimination using voice signals is a non-invasive method that can carry out the examination rapidly and simply without giving discomfort to the patients. n appropriate analysis parameters and classifiers are developed, this method can be used effectively in various applications including telemedicine. This study examines voice analysis parameters used for laryngeal disease discrimination to help discriminate laryngeal diseases by voice signal analysis. The study also estimates the laryngeal cancer discrimination activity of the Gaussian mixture model (GMM) classifier based on the statistical modelling of voice analysis parameters. Materials and Methods : The Multi-dimensional voice program (MDVP) parameters, which have been widely used for the analysis of laryngeal cancer voice, sometimes fail to analyze the voice of a laryngeal cancer patient whose cycle is seriously damaged. Accordingly, it is necessary to develop a new method that enables an analysis of high reliability for the voice signals that cannot be analyzed by the MDVP. To conduct the experiments of laryngeal cancer discrimination, the authors used three types of voices collected at the Department of Otorhinorlaryngology, Pusan National University Hospital. 50 normal males voice data, 50 voices of males with benign laryngeal diseases and 105 voices of males laryngeal cancer. In addition, the experiment also included 11 voices data of males with laryngeal cancer that cannot be analyzed by the MDVP, Only monosyllabic vowel /a/ was used as voice data. Since there were only 11 voices of laryngeal cancer patients that cannot be analyzed by the MDVP, those voices were used only for discrimination. This study examined the linear predictive cepstral coefficients (LPCC) and the met-frequency cepstral coefficients (MFCC) that are the two major cepstrum analysis methods in the area of acoustic recognition. Results : The results showed that this met frequency scaling process was effective in acoustic recognition but not useful for laryngeal cancer discrimination. Accordingly, the linear frequency cepstral coefficients (LFCC) that excluded the met frequency scaling from the MFCC was introduced. The LFCC showed more excellent discrimination activity rather than the MFCC in predictability of laryngeal cancer. Conclusion : In conclusion, the parameters applied in this study could discriminate accurately even the terminal laryngeal cancer whose periodicity is disturbed. Also it is thought that future studies on various classification algorithms and parameters representing pathophysiology of vocal cords will make it possible to discriminate benign laryngeal diseases as well, in addition to laryngeal cancer.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.43-46
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• 2008

Background and Objectives : Clinical suspicion and appropriate diagnostic procedures are essential for the timely management of extrapulmonary type of mycobacterial disease. In the hope of suggesting a suitable guideline for the early diagnosis of laryngeal tuberculosis, the authors reviewed their clinical pathways and the characteristics of patients with laryngeal tuberculosis who were managed in the recent 10 years at a single tertiary referral hospital, Samsung Medical Center. Subjects and Method : Retrospective chart review was performed for the 25 adult patients with laryngeal tuberculosis. Among 25 cases, 12 were pathologically confirmed by laryngeal biopsy and the other 13 were clinically diagnosed by cumulative clinical information; definite laryngitis on laryngoscopy, positive AFB (acid fast bacillus) smear/culture or active pulmonary tuberculosis on chest X-ray, and substantial response to anti-tuberculosis medication. Results : Chest X-ray revealed active pulmonary tuberculosis in 72% of patients (N=18/25). Sputum AFB smear/culture was positive in 95% of all tested patients (N=21/22) and in 100% of the tested patients who have stable or no evidence of pulmonary tuberculosis (N=5/5). All patients except one who had coexisting laryngeal malignancy showed considerable improvement in their subjective symptoms and laryngeal findings within the first 2 months of anti-tuberculosis medications and they achieved complete response on subsequent sputum studies, chest X-ray and laryngeal findings after $7.0{\pm}2.3$ months of the medications. Conclusion : We suggest that chest X-ray and sputum AFB smear/culture to be the first step of work-up for the patients having laryngeal tuberculosis in suspicion since laryngeal tuberculosis is largely associated with active pulmonary tuberculosis and/or sputum AFB study offers high yield even in case of primary laryngeal tuberculosis. However laryngeal biopsy must be considered in case showing unsatisfactory response to the anti-tuberculosis medication for more than 2 months.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1978년도 제12차 학술대회연제 순서 및 초록
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• pp.7.1-7
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• 1978

후두의 Microsurgery는 육안으로 관찰할 수 없는 작은 병변을 그 초기에 발견하고 치료하는데 유익하며 이는 근년에 와서 Scale(1960), Kleinsasser(1964) 등에 의해 개발되었고 Saito 및 많은 임상가들에 의해 추시된 바 있으며, 노도 그의 경험 20여례에 대하여 상세한 보고를 하였다. 귀수술에 사용되는 zeiss 수술현미경의 대물 lens 위에 보조 lens를 장치하여 충분한 작동거리를 확보할 수 있으며, 나아가 fiber optics에 의한 suspeasion laryngoscope로써 시야를 밝게 할 수 있으며, 따라서 정확한 진단 및 세밀한 수술을 할 수 있다. 즉 점막상피내암, 후두점막질환, 성대 polyp, nodule및 cyst 등에 대한 현대적 진단과 치료법이기도 하다. 저자 등은 전남의대 부속병원 이비인후과를 내원한 후두질환 환자중 선택적으로 suspension laryngomicr-oscopy를 이용하여 진단 및 외과적 적출을 시행한 11례(성대 polyp; 4례, 유두종; 4례, 진성대 및 가성대의 web형성; 1례, 후두외상; 1례, 후두상피세포암: 1례)를 경험하였기에 우선 예보를 하는 바이며, 앞으로 지속해서 많은 경험증례를 분석검시하여 보고하겠다.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.61-65
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• 2020

Background and Objectives The overall incidence of laryngeal tuberculosis (LT) has generally decreased over the recent years, yet there is still a discrete population of patients newly diagnosed with the disease. This study is aimed to examine the patients with LT over the recent 10 years and to investigate the changes in clinical pattern with respect to the past period. Materials and Method A retrospective review has been performed on 20 patients who have been initially diagnosed with LT between 2005 and 2015. Results The age of the patients ranged from 25 years to 95 years with an average age of 45.6 years. Seventeen patients (85%) showed hoarseness, which was the most common clinical symptom. Most affected lesion was the true vocal cord. Laryngoscopic examination showed various clinical manifestations: polypoid 30%, granulomatous 25%, nonspecific 25%, ulcerative 20%. A variety of methods were used for diagnostic confirmation of LT [acid-fast bacilli (AFB) smear 45%, AFB culture 40%, polymerase chain reaction 30%, surgical pathology 45%]. Coexisting pulmonary tuberculosis (PT) was detected in 10 patients (50%). Relative to the patients with inactive PT or normal lung status, those with active PT showed higher incidence of laryngeal lesions located in areas other than true vocal cord (p=0.050). Conclusion Based on the analytic results from this study, laryngologists should recognize the changes in the recent clinical patterns of LT and always be ready for clinical suspicion of this disease on such atypical laryngeal findings which can often mimic laryngeal malignancies to provide the pertinent treatment.

• 말소리와 음성과학
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• 제14권4호
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• pp.35-43
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• 2022

본 논문은 후두 장애음성 데이터의 식별률을 CNN과 기계학습 앙상블 학습 방법에 의해 개선하는 방법에 대한 연구이다. 일반적으로 후두 장애음성 데이터는 그 수가 적으므로 통계적 방법에 의해 식별기가 구성되더라도, 훈련 방식에 따라 과적합으로 인해 일어나는 현상으로 인해 외부 데이터에 노출될 시 식별률의 저하가 발생할 수 있다. 본 연구에서는 다양한 정확도를 갖도록 훈련된 CNN 모델과 기계학습 모델로부터 도출된 결과를 다중 투표 방식으로 결합하여 원래의 훈련된 모델에 비해 향상된 분류 효율을 갖도록 하는 방법과 함께, 기존의 기계학습 중 앙상블 방법을 적용해 보고 그 결과를 확인하였다. 알고리즘을 훈련하고 검증하기 위해 PNUH(Pusan National University Hospital) 데이터셋을 이용하였다. 데이터셋에는 정상음성과 양성종양 및 악성 종양의 음성 데이터가 포함되어 있다. 실험에서는 정상 및 양성 종양과 악성종양을 구분하는 시도를 하였다. 실험결과 random forest 방법이 가장 우수한 앙상블 방법으로 나타났으며 85%의 식별률을 보였다.

• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 1996년도 제13차 학술대회 연제순서 및 초록집
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• pp.252.2-253
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• 1996