• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.9 no.1
• /
• pp.38-42
• /
• 1998

It has been reported that Tonsillectomy ＆ Adenoidectomy(T & A) resulted in the change of voice by structural changes directly to the vocal track. We studied the effect of T & A on the voice of patients comparing the pre-operative to the post-operative voice. It was performed using a Computerized Speech Lab(CSL50) which is currently used as a method for voice analysis. Forty-five patients who had T＆A, aging from 3 to 42 years old, took part in studies and wert evaluated for voice changes and the degree of formant changes of four basic vowels, /a/, /i/, /o/, and /u/. They were evaluated pre-operatively and post-operatively one month later using MDVP, CSL program of CSL50. The results obtained were as follows ; In using MDVP, there were some differences between pre-operative and post-operative shimmer measures within the normal range but other acoustic measures(Fo, jitter, NHR) show no significant differences(p>0.05). F3 of /a/ and /o/ were significantly decreased(p<0.05) and F2, F3 of /i/ were increased(p>0.05) in patients who only had Tonsillectomy in doing CSL spectrogram. For the patients who had T & A, Fl and F3 of /a/, F3 of /i/, Fl, F2 and F3 of /o/ were decreased with significant increase in F1 and F2 of /i/(p<0.05).

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.19 no.1
• /
• pp.7-10
• /
• 2008

The early glottic cancers are traditionally treated by radiotherapy or endoscopic surgery. The excellent effectiveness of both treatment modalities for local control, larynx preservation, and disease specific death is similar. Therefore, functional voice outcome after treatment is one of the most important factors in the choice of treatment for early glottic cancer. To assess the functional outcomes and compare the voice quality in patients with early glottic cancer treated with curative intent with radiotherapy or laser cordectomy, we performed literature review. Most studies showed that the voice quality after radiation therapy is slightly better than that after laser cordectomy. Subanalysis according to types of laser cordectomy, however, indicates that voice quality depends on type of laser cordectomy. Especially, type I or type II laser cordectomy might be superior to other types of laser cordectomy and radiation therapy. We conclude that the laser cordectomy is a good surgical alternative for properly selected early glottic cancer including professional voice users.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.8 no.2
• /
• pp.161-165
• /
• 1997

Background : The rhinomanometry and acoustic rhinometry can assess e nasal passage dynamically and statically Recently, analytic methods such as nasometer and sound spectrogram are gaining wide attention to evaluate the nasality objectively. Objectives : firstly to determine if ere was a relationship between the new methods and nasal airway resistance, and secondly to establish if the measurement of nasalance and sound spectrum could be used as an alternative to rhinomanometry and acoustic rhinometry. Materials and Methods : Thirty two patients who underwent either septoplasty and turbinectomy for nasal obstruction were studied. And their ages ranged form 15 to 45 years, with an average of 26.1 years. The rhinomanometry, nasometer, sound spectrogram were performed at preoperative and postoperative 4 weeks day. Results : After operation, subjective symptoms and rhinomanometric results were significantly improved but nasalance and slope of nana, mama and mamma passage had not meningful change. The significnat changes were noted in nasalance and first nasal formant frequency of nasal consonant of velum(angang). Conclusion : Nasometer and sound spectrogram had a limitation for the measure of nasal patency.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.27 no.2
• /
• pp.108-113
• /
• 2016

Background and Objectives : After thyroidectomy, many patients experience problems report such things as reduced voice range and vocal fatigue, swallowing problems without superior and recurrent laryngeal nerve injury. The purpose of this study was to evaluate voice and swallowing problems before and after thyroid surgery without laryngeal nerve injury. Materials and Methods : Ninety-three patients who underwent thyroidectomy without laryngeal nerve injury and completed the follow-up evaluations were studied between June 2013 and December 2015. Each evaluation was performed preoperatively, as well as 1 week, 1 month postoperatively. Analysis was performed including voice handicap index (VHI), dysphagia handicap index (DHI), and acoustic voice analysis. Results : Patients show significant variation of parameters in the fundamental frequency (F), maximal phonation time (MPT), shimmer, jitter and soft phonation index (SPI) early after operation, and most of them showed recovery of parameters after 1month of operation. Perceptive complaint of voice and swallowing also showed significant decreased after operation (p<0.005). After 1month of operation, MPT, highest frequency and frequency ranges still showed significant decreased parameters. Comparing acoustic and perceptive parameters of total thyroidectomy and lobectomy, there was no significant changes between them except highest frequency (p=0.042). Conclusion : The results from both subjective and objective evaluations show voice and swallowing disturbance after thyroidectomy even in the absence of laryngeal nerve and provide patients information about the recovery process after surgery. Highest frequency parameter showed most significant changes after operation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.19 no.1
• /
• pp.11-15
• /
• 2008

Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.

• Korean Journal of Head & Neck Oncology
• /
• v.30 no.2
• /
• pp.39-42
• /
• 2014

Background and Objectives : Pharyngocutaneous fistula is the most common complication after total laryngectomy. The objective of this study was to determine the incidence of pharyngocutaneous fistula after total laryngectomy in patients operated on in our department and to establish whether specific factors predispose to fistula formation. Materials and Methods : For 10 years(2003-2014), 49 cases of patients who were diagnosed with laryngeal cancer and underwent total laryngectomy in our department. Patients who underwent radiotherapy before the surgery was 24 cases(48.9%) of all total laryngectomy patients. And those who were needed flap reconstruction because of extensive tumor involvement to hypopharynx were also 24 cases(48.9%), whereas primary closure were performed in 25 cases(51%). Results : The postoperative pharyngocutaneous fistula was found in 12 of the 49 patients(24.5%). The radiotherapy before surgery was a statistically significant factor that increase the incidence of postoperative fistulas(p=0.037). Large extent of surgery including flap reconstruction was almost statistically significant factor of raising postoperative fistula rates(p=0.051). Conclusion : According to this study, the presence of postoperative fistula seems to be influenced by previous radiotherapy and the extent of surgery. These could be the risk factors of pharyngocutaneous fistula after total laryngectomy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.18 no.1
• /
• pp.62-66
• /
• 2007

Objectives: There is a perception that a total laryngectomy has a devastating effect on patients and their families, but only a few studies have addressed long-term quality of life (QOL) after laryngectomy. Materials and Methods: A cross-sectional study of 32 patients more than 3 years since laryngectomy was performed. Patients were asked to complete the SF-36 questionnaire before surgery and within 3-5 years after surgery. Preoperative and postoperative SF-36 scores were compared with data on 46 age-matched healthy controls. Results: The most of SF-36 subscale scores showed significant deterioration after surgery. Preoperative scores had significantly poorer than the normal controls on 6 subscales, and also postoperative scores was lower than normal controls on 2 subscales. Conclusion: In the study, the quality of life of the patients who underwent total laryngectomy show poorer scores than pre operative status and normal controls.

• Proceedings of the KSLP Conference
• /
• 1994.06b
• /
• pp.87-87
• /
• 1994

편측 성대마비에 의한 부전의 수술적 치료로는 그 동안 테플론주입에 의한성대내측전위술, 제1형 갑상연골성형술, 또는 피열연골내전술 등이 이용되었으며, 성대부전이 심하거나 성대높이에 차이가 있을 때는 제1형 갑상연골성형술 등에 비해 피열연골내전술이 좋은 결과를 보이는 것으로 보고되고 있다 그러나, 성대의 움직임은 있으면서 뒷쪽에 심한 성대부전(posterior glottic chink)을 보이는 경우에는 아직은 특별한 수술적인 방법이 없는 바, 저자들은 갑상선 부분절제술 후에 생긴 양쪽성대의 움직임은 있으면서 성문 뒷쪽에 심한 부전을 보인 발성장애 환자 1례에서 제1형 갑상연골성형술과 동시에 피열연골내전술을 시행하여 좋은 결과를 얻었기에 보고하는 바이다. (중략)

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1982.05a
• /
• pp.7.3-7
• /
• 1982

Endotracheal intubation is common practice for either general anesthesia or keeping artificial airway in various conditions. Despite of its great usefulness, however, laryngeal edema, ulceration, and granuloma are occasionally developed following endotracheal intubation as posttraumatic complications. Vocal cord paralysis is also rarely developed. Recently we experienced a case of left vocal cord paralysis with accompanying hoarseness following endotracheal general anesthesia for appendectomy. The symptoms of hoarseness and sore throat developed immediately after the general anesthesia. Periodic check revealed gradual return to normal function of the paralyzed cord with the complete function about 3 months after the anesthesia.

• Korean Journal of Head & Neck Oncology
• /
• v.23 no.1
• /
• pp.15-20
• /
• 2007

Background and Objectives：Supraglottic partial laryngectomy is oncologically sound surgical procedure for selected cases of laryngeal cancer which maintains physiologic speech and swallowing without permanent tracheostoma. The purpose of this study is to evaluate the oncologic and functional results of supraglottic partial laryngectomy and neck dissection for supraglottic cancer. Materials and Methods：Between 1991-2005, Twenty-three supraglottic cancer patients, underwent supraglottic partial laryngectomy, were studied retrospectively. There were 5 patients with cT1, 14 with cT2, 4 with cT3 and 11 patients with cN0, 1 with cN1, 10 with cN2, 1 with cN3. All patients underwent neck dissection and postoperative radiotherapy was added to twenty patients. They were reviewed with respect to primary subsites, extended subsites, treatment result, survival rate, factors affecting the prognosis, postoperative complication, time of decannulation and oral diet, and postoperative voice. Results：Among eleven patients with clinically negative node, six patients had pathologically positive nodes. So occult metastasis was 54.5%. Two patients recurred at cervical lymph node and one had distant metastasis to lung. Local and regional control were 100% and 91.3%. The overall 3-year and 5-year survival rate were 84%, 78%, respectively. Nineteen cases were squamous cell carcinomas and four were basaloid squamous cell carcinomas. Basaloid subtype was significantly affected to survival. Decannulation and oral feeding were possible in 100%. Conclusions：Supraglottic partial laryngectomy is oncologically safe and functionally good procedure in supraglottic cancers. Elective neck dissection is beneficial in management of occult cervical metastasis.