• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.5-10
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• 2016

Variable systemic diseases affect larynx and vocal fold and result in voice change. Asthma and chronic obstructive pulmonary disease make increase of intra-abdomimal pressure followed by reflux of gastric acid, which stimulate vagal-bronchopulomary reflex aggravating cough and respiratory disturbance. Fungal laryngitis in the general population is extremely rare, but can occur in immunocompromised AIDS patients. Although, initially, empirical antifungal therapy for candidiasis is often given without biopsy, diagnostic direct laryngoscopy and biopsy is imperative if a substantial clinical response is not rapidly achieved. In the highly active anti-retroviral therapy era, HIV-positive patients are living longer and are at higher risk for developing non-AIDS-defining malignancies. The incidence of head and neck cancer (HNC) which is related with human papilloma virus infection has increased. The survival is significantly lower among the AIDS-HNC patients with CD4 counts ${\leq}200cells/{\mu}L$. Rheumatoid arthritis (RA) cause voice disturbance by developing cricoarytenoid joints fixation or nodule on vocal fold. Post-menopausal voice disorder (PMVD) is caused by decreased secretion of estrogen-progesterone resulting in decrease of fundamental frequency (F0). Hormonal replacement therapy is helpful to reduce F0 decrease. RA and PMVD result in slight voice change, but it could crucial in professional voice user.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.75-81
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• 1997

The clinical investigation was done in the 42 patients with bilateral vocal cord palsy who visited the otorhinolaryngologic department of the Yongdong Severance Hospital during the 10-year period between August 1986 to August 1996. On the sex and age distribution, the ratio of male to female patients was 2.8 : 1 and the age was evenly distributed and average was 46 years old. Of their chief complaints, dyspnea was the most common symptom. Among the position of the paralyzed vocal cords, paramedian position was most common. The most common causes of the bilateral vocal cord palsy was idiopathic Other causes include iatrogenic, prolonged intubation, head ＆ neck trauma, brain tumor, Myasthenia Gravis, and mediastinitis. Our treament results were as follows. Recovery rate of idiopathic bilateral vocal cord palsy was 77.7% and recovery period after bilateral vocal cord palsy was shortened remarkedly after use with steroid. We performed laser arytenoidectomy in patients with irreversible idiopathic vocal cord palsy, neural injury, and cricoarytenoid joint fixation. Decannualtion was possible to be carried out in 86% of the patients and none of complication except for 1 case of aspiration developed. Thus we concluded that it was meaningful surgical treatment of bilateral vocal cord palsy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.9-13
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• 2018

Postoperative airway aspiration is not uncommon in patients with head and neck cancer. Airway aspiration has serious consequences, such as swallowing disorders, nutrition-related health problem, or reducing the quality of life due to maintenance of tracheal or nasogastric tubes. The postoperative oropharyngeal defect due to the surgery may interfere with normal swallowing reflex, or the laryngeal dysfunction caused by radiation therapy may cause severe airway aspiration, which may lead to complications such as dyspnea and pneumonia. Complete removal of the disease is also important in the treatment of head and neck cancer, but it is necessary to select a method to avoid and predict the occurrence of airway aspiration according to the treatment method. The most important factor to prevent airway aspiration after surgery is to preserve the proper volume of the oropharynx and to preserve at least one of the cricoarytenoid joint function. It is also the most effective way to reduce additional complications by seeking appropriate surgical treatment according to airway aspiration status. The purpose of this study is to review the operative methods that can induce airway aspiration and consider the prevention and treatment strategy through review of the literature.

• Proceedings of the KIEE Conference
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• 2007.10a
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• pp.475-476
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• 2007

Electroglottography (EGG) is a technique used to register laryngeal behavior indirectly by a measuring the change in electrical impedance across the throat during speaking. However, EGG waveform is affected by laryngeal muscles which fluctuate the vocal cords, and which result in baseline wander. It is required to reduce baseline wander in EGG waveform, because EGG waveform is used for input signal of nonlinear speech synthesizer in next chapter. In vocal cords, the abduction-adduction of glottis is mainly controlled by the posterior cricoarytenoid (abductor) and interarytenoid (adductor) muscles respectively. Empirical Mode Decomposition method was adopted in cancellation of EGG waveform baseline wandering, and showd better performance than that of high pass filter with 500 order.

• Speech Sciences
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• v.9 no.1
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• pp.17-26
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• 2002

Voice onset time (VOT) is defined as the time interval from the oral release of a stop consonant to the onset of glottal pulsing in the following vowel. VOT is a temporal characteristic of stop consonants that reflects the complex timing of glottal articulation relative to supraglottal articulation. There have been many reports on efforts to clarify the acoustical and physiological properties that differentiate the three types of Korean stops, including acoustic, fiberscopic, aerodynamic and electromyographic studies. In the acoustic and fiberscopic studies for stop consonants, the voice onset time and glottal width during the production of stops has been known as the longest and largest in the heavily aspirated type followed by the slightly aspirated type and unaspirated types. The thyroarytenoid and posterior cricoarytenoid muscles were physiologically inter-correlated for differentiating these types of stops. However, a review of the English literature shows that the fine movement of the mucosal edges of the vocal folds during the production of stops has not been well documented. In recent. years, a new method for high-speed recording of laryngeal dynamics by use of a digital recording system allows us to observe with fine time resolution. The movements of the vocal fold edges were documented during the period of stop production using a fiberscopic system of high speed digital images. By observing the glottal width and the visual vibratory movements of the vocal folds before voice onset, the heavily aspirated stop was characterized as being more prominent and dynamic than the slightly aspirated and unaspirated stops.

• Journal of Korean Neurosurgical Society
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• v.48 no.5
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• pp.406-411
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• 2010

Objective : Esophageal/hypopharyngeal injury can be a disastrous complication of anterior cervical surgery. The amount of hypopharyngeal wall exposure within the surgical field has not been studied. The objective of this study is to evaluate the chance of hypopharyngeal wall exposure by measuring the amount of axial rotation of the thyroid cartilage (ARTC) and posterior projection of the hypopharynx (PPH). Methods : The study was prospectively designed using intraoperative ultrasonography. We measured the amount of ARTC in 27 cases. The amount of posterior projection of the hypopharynx (PPH) also was measured on pre-operative CT and compared at three different levels; the superior border of the thyroid cartilage (SBTC), cricoarytenoid joint and tip of inferior horn of the thyroid cartilage (TIHTC). The presence of air density was also checked on the same levels. Results : The angle of ARTC ranged from $-6.9^{\circ}$ to $29.7^{\circ}$, with no statistical difference between the upper and lower cervical group. The amount of PPH was increased caudally. Air densities were observed in 26 cases at the SBTC, but none at the TIHTC. Conclusion : Within the confines of the thyroid cartilage, surgeons are required to pay more attention to the status of hypopharynx/esophagus near the inferior horn of the thyroid cartilage. The hypopharynx/esophagus at the TIHTC is more likely to be exposed than at the upper and middle part of the thyroid cartilage, which may increase the risk of injury by pressure. Surgeons should be aware of the fact that the visceral component at C6-T1 surgeries also rotates as much as when the thyroid cartilage is engaged with a retractor. The esophagus at lower cervical levels warrants more careful retraction because it is not protected by the thyroid cartilage.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.1
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• pp.40-46
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• 2003

Background and Objectives : The vocal fold granuloma has been associated with vocal abuse, gastroesophageal reflux, endotracheal intubation and habitual throat clearing etc.. Granuloma is benign growth of hypertrophic granulation tissue. It is usually located on the posterior third of vocal fold, in one or both vocal process of the arytenoid cartilage In spite of the voice therapy, steroid therapy, anti-reflex therapy and surgical procedure. The distinct advantage and uniform success rate of each methods have not been generally shown. Authors report that localized injection of botulinum toxin type A (BOTOX$^{\circledR}$) is the promising method both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy or who are poor surgical candidates. Materials and Method : We carried out a retrospective study of 9 patients with the diagnosis of vocal fold granuloma on the videostroboscopic examination from Jan 2000 to Mar 2003. The botulinum toxin type A was injected into one or both thyroarytenoid muscle or lateral cricoarytenoid muscle under the electromyography. The average dosage ranges from 6U to 8U per injection. Results : Unilateral vocal fold granuloma in 7 patients had been resolved completely within 2-3 months after first injection : 5 patients received th\ulcorner GER medical therapy in addition to the Botulinum toxin injections, 2 patients was resolved completely who had shown recurrence after $CO_2$ laser vaporization. 2 patients who had shown recurrence after $1^st$ injection were also completely resolved within 6 months after further injections. Conclusion : We expect that localized injection of Botulinum toxin type A can provide an alternative treatment for the refractory cases to the traditional forms of therapy and avoid the recurrence in conjunction with proper medical and voice therapy against GER and vocal abuse.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.15-15
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• 1991

한국어 자음에 대한 생리적인 분류는 조음점 및 조음발법에 따라 다시 세분화할 수 있는데 그중에서 조음발법에 따라 파열음, 마찰음, 파찰음 및 비음들 여러가지로 분류할 수 있다. 그중 특히 파열음은 그 개방하는 방법에 따라 연음(lenis), 경음(glottalized) 및 기식음(aspirated)등으로 구분하는데 이러한 각음을 육안으로 확인하면 모음이 발성되기 위한 성대진동이 있기전의 자음을 위한 성대의 운동의 현상을 보면 기식음에서는 성대열림이 가장 크고 연음에서도 열림이 크지만 기식음보다는 적고 경음에서는 성대의 열림이 가장 작았다. 이러한 현상은 후두내시경에 의해 쉽게 확인할 수 있었는데 이것을 과학적으로 규명하기 위해서는 여러연구에 의해 가능하나 흔히 후두근전도 검사에 의한 성대내전근과 외전근의 역할의 차이를 비교함으로서 가능해지리라 예상되어 본 연구를 시행하였다. 사용된 문형 또는 단어는 한가지를 제외하고는 모두 의미있는 단어를 사용하였으며 EMG recording을 위해 사용된 근육은 후두내전근인 Vocalis muscle과 후두외전근인 Posterior cricoarytenoid muscle이 사용되었고 전기신호는 computer data processing system에 의해 분석되어졌다. 결과는 내시경에 의한 성대열림의 거리측정 결과를 분석함과 동시에 후두내근에 대한 근전도검사에 의한 분석을 토대로 하였으며 이를 간단히 설명하면 이제까지 많은 사람들은 한국어 자음에 대한 각각의 특징적인 현상들을 주로 성대내전근의 역할에 의해 규명하였으나 본 결과로는 성대내전근의 역할도 중요하지만 성대외전근의 역할 또한 상호 연관성을 가지면서 매우 중요한 역할을 한다는 점이다.for the Isotropic plates can be used. Use of some coefficients can produce "exact" value for laminates with such configuration.trap with 2.88[eV] deep of injected space charge from the chathode in the crystaline regions. The origin of ${\alpha}$$_2$ peak was regarded as the detrapping process of ions trapped with 0.9[eV] deep originated from impurity-ion remained in the specimen during production process of the material, in the crystalline regions. The origin of ${\beta}$ peak was concluded to be due to the depolarization process of "C=0"dipole with the activation energy of 0.75[eV] in the amorphous regions. The origin of ${\gamma}$ peak was responsible to the process combined with the depolarization of "CH$_3$", chain segment, with the activation energy of carriers from the shallo

• Korean Journal of Head & Neck Oncology
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• v.37 no.1
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• pp.63-66
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• 2021

Supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) involves the removal of the whole thyroid cartilage, both true and false vocal cords, the ventricles, and the paraglottic spaces, sparing the cricoid cartilage, hyoid bone, and at least one functional and mobile cricoarytenoid unit. Reconstruction is performed by suturing of the cricoid cartilage up tightly to the hyoid bone, so trachea-releasing procedures are needed to prevent leakage at anastomosis site. In case of advanced tranglottic cancer invading tracheal tracheal wall, we need to perform additional circumferentrial circumferential tracheal wall resection. However, when we perform SCPL, circumferential resection of tracheal wall is limited because SCPL procedure itself needs releasing of tracheal length. We report a case of advanced transglottic cancer involving tracheal wall treated with induction chemotherapy and SCPL including tracheal wall resection with reconstruction of tracheal defect by sternocleidomastoid muscle flap covered with skin graft.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.1
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• pp.23-27
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• 2006

Purpose: There are a few case reports on asymmetric vocal cord uptake on FDG-PET in patients with unilateral vocal cord paralysis, which could be a potential pitfall in the interpretation of FDG-PET images. We evaluated the metabolic activity of laryngeal muscles of patients with unilateral vocal cord paralysis in comparison to normal controls during both speech and silence. Methods: Eleven patients with unilateral vocal cord palsy (thyroldectomy=7, lung cancer=1, others=3) and 12 normal controls underwent FDG-PET with usual protocol. They were divided into two groups respectively; one group read books aloud for 20 minutes (phonation group) and the other kept silence (non-phonation groups) after FDG injection. Recent neck CT scan were co-registered with FDG-PET to produce PET-CT fusion images to elaborate small laryngeal muscles. Results: In patients with unilateral vocal cord palsy, contralateral non-paralyzed vocal cord showed hypermetabolism mainly on thyroarytenoid muscle, more intensely with phonation group ($SUV=5.88{\pm}2.65$) than with non-phonation group ($SUV=2.30{\pm}0.39$). Normal control subjects showed hypermetabolism ($3.68{\pm}0.96$) in interarytenoid muscle and symmetric mild hypermetabolism in both lateral cricoarytenoid muscles in only phonation group. Conclusion: FDG-PET with fusion images using CT scan in patients with unilateral vocal cord paralysis showed hypermetabolism of contralateral non-paralyzed thyroarytenoid muscle, suggesting compensatory action during phonation. Phonation durung FDG PET study enhanced FDG uptake on different laryngeal muscles between patients with unilateral vocal cord paralysis and normal subjects.