• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.2
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• pp.96-100
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• 2008

Laryngeal stroboscopy is a important clinical tool in the diagnosis and evaluation of patients with voice disorders. Stroboscopic parameters evaluated during examination include symmetry, periodicity, glottic losure, amplitude, mucosal wave, and amplitude. Stroboscopy can provide useful information on glottal closure patterns in patient with/without vocal fold pathology and this paper describes the stroboscopic findings of the laryngeal pathologic lesions.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.31-31
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• 1991

후두격막은 1822년 Fleichman이 호흡곤란과 발성장애를 야기한 례를 최초로 보고하였으며 선천성으로나 후천성으로 발생할 수 있다. 선천성후두격막은 태생 10주경의 후두발생장애로 발생한다고 알려져 있으며 성문부위에서 가장 많이 발견되며 후천성후두격막은 감염, 외상, 수술 및 방사선조사 후 발생한다. 저자들은 최근 1례의 선천성후두격막과 4례의 후천성후두격막환자를 치험하였기에 문헌고찰과 함께 보고하는 바이다.

• Proceedings of the KSLP Conference
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• 1998.11a
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• pp.195-195
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• 1998

성문부폐쇄부전(glottic insufficiency)를 수술적으로 치료하기 위한 노력은 여러 형태(silicone, hydrogen gel, teflon, etc.)의 성대이물주입술, 갑상성형술등 다양하게 시도되어 왔다. 그러나, 이러한 노력에도 불구하고 성문부폐쇄부전은 여전히 해결하기 어려운 문제로 남아있다. 여기에 1995년 Ford 등은 성문부폐쇄부전에 이은 음성장애치료의 새로운 접근방법으로 자가 콜라겐주입술(autologous collagen injection)을 소개하였다. (중략)

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.1
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• pp.11-16
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• 2001

Background and Objectives : A burn injury to the glottis differs from a burn injury to the trachea, bronchi, and lung parenchyma, in that thermal injury does not occur to any significant degree below the level of the larynx, due to the effective cooling of air by the upper airway and to reflex closure of the vocal cords from a blast of hot air. Therefore, the laryngeal inhalation injury give rise to airway problem and voice change. The objectives of this study is to assess management of laryngeal inhalation injury and voice change after management. Materials and Methods : Voice choses and laryngeal injuries of eight laryngeal inhalation patients were analyzed through questionnaire, voice dynamic laboratory, and laryngeal stroboscopy. Operative management was performed to five patients for airway patiency and vocal cord movement on laryngeal pathology ind voice therapy was performed to all patients. One-year after, voice changes and laryngeal injuries were reanalyzed with same methods. Results : Vocal breathiness, decreased voice intensity, reduced voice range, and easy fatigability were major complaints of laryngeal inhalation patients. Glottic stenosis were developed to five of eight patients, and vocal cord atrophy, bowing were developed to others. Vocal cord mucosal waves were significantly decreased in all patients. Jitter(%), Shimmer(dB) were increased and Maximal phonation time(MPT) was decreased. One-year after, subjective voice changes and objective voice parameters were improved. And vocal cord mucosal waves were recovered in all patients. Conclusions : Subjective voice quality and objective voice parameters were improved after operative management for laryngeal pathology and voice therapy. And we observed recovery of vocal fold mucosal waves by laryngeal stroboscopy. We think that early preventable tracheotomy is necessary to reduce the laryngeal contact injury in laryngeal inhalation patients.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.5 no.1
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• pp.5-10
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• 1994

In vivo canine model was made in two mongrel dogs under the general Ⅰ-Ⅴ anesthesia. A vertical skin incision was made on the neck, the larynx and the trachea were dissected. Two tracheal openings were made : lower one for the insertion of the anesthesia tube and upper one for the delivery of air to the larynx to induce phonation. External branch of the superior laryngeal nerves and recurrent laryngeal nerves bilaterally were identified and stimulated electrically constantly. Subglottic pressure. fundamental frequency, intensity, and open quotient were measured when the air flow rate was varying low, medium and high. Glottic resistence was calculated. As the air flow rate was increased, the subglottic pressure and the sound intensity were increased. However, glottic resistance was decreased as the air flow was increased. In falsetto register, fundamenatal frequency was increased with the increment of air flow, but in modal register fundamental frequency was not increased statistically significant Open quotient by the electroglottography was increased according to the increment of airflow.

• Radiation Oncology Journal
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• v.37 no.2
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• pp.82-90
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• 2019

Purpose: To evaluate the results of hypofractionated radiotherapy (HFX) for early glottic cancer. Materials and Methods: Eighty-five patients with cT1-2N0M0 squamous cell carcinoma of the glottis who had undergone HFX, performed using intensity-modulated radiotherapy (IMRT, n = 66) and three-dimensional conformal radiotherapy (3D CRT, n = 19) were analyzed. For all patients, radiotherapy was administered at 60.75 Gy in 27 fractions. Forty-three patients received a simultaneous integrated boost (SIB) of 2.3-2.5 Gy per tumor fraction. Results: The median follow-up duration was 29.9 months (range, 5.5 to 76.5 months). All patients achieved complete remission at a median of 50 days after the end of radiotherapy (range, 14 to 206 days). The 5-year rates for locoregional recurrence-free survival was 88.1%, and the 5-year overall survival rate was 86.2%. T2 stage was a prognostic factor for locoregional recurrence-free survival after radiotherapy (p = 0.002). SIB for the tumor did not affect disease control and survival (p = 0.191 and p = 0.387, respectively). No patients experienced acute or chronic toxicities of ≥grade 3. IMRT significantly decreased the dose administered to the carotid artery as opposed to 3D CRT (V₃₅, p < 0.001; V₅₀, p < 0.001). Conclusions: Patients treated with HFX achieved acceptable locoregional disease control rates and overall survival rates compared with previous HFX studies. A fraction size of 2.25 Gy provided good disease control regardless of SIB administration.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.28-32
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• 2005

Background and Objectives : The most important two factors of the voice production are the respiratory function which is the power source of voice and the glottic closure that transform the air flow into sound signals. The purpose of this study was to investigate the differences between trained singers and untrained controls under varying intensity at a constant vocal pitch by simulataneous using the airway interruption method and electroglottography(EGG). Materials and Methods : Under two different intensity condition at a constant vocal pitch(/G/), 20(Male 10, Female 10) trained singers were studied. Mean flow rate(MFR), subglottic pressure(Psub) and intensity were measured with aerodynamic test using the Phonatory function analyzer. Closed quotients(CQ), jitter and shimmer were also investigated by electroglottography using Lx speech studio. These data were compared with that of normal controls. Results : MFR and Psub were increased on high intensity condition in all subject groups but there was no statistically significance. Statistically significant increasing of CQ. were observed in male trained singers on high intensity condition (untrained male : 51.31${\pm}$3.70%, trained male :55.52${\pm}$6.07%, p=.039). Shimmer percent, one of the phonatory stability parameters, was also decreased statistically in all subject groups(p<.001). Conclusion : The trained singers' phonation was more efficient than untrained singers. The result means that the trained singers can increase the loudness with little changing of mean flow rate, subglottic pressure but more increasing of glottic closed quotients.

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

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.99-103
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• 2014

A laryngeal web is connective tissue covered with epithelium stretching between both sides of the true vocal cords. Laryngeal webs were first reported by Fleischmann in 1882, and they cause upper airway obstruction and abnormalities of phonation. Congenital webs result from an arrest of reabsorption of the epithelium of the larynx at the tenth week of the fetus. The most common site of webbing is the anterior commissural glottic area, followed by other glottic areas and rarely subglottic or supraglottic areas. We have experienced two cases of congenital laryngeal webs. The webs were operated in two different methods. The first was excised under magnified vision through a laryngoscope, with a silastic keel secured between the raw surfaces of the separated mucosa. In the second case, the deepithelialized surfaces were exposed for a certain time length to mitomycin C to prevent postoperative webbing. We, hereby, report our experience of the diagnosis and management of two cases of a rare entity known as the congenital laryngeal web, and discuss the results with relevant studies.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.8.1-8
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• 1979

Microsurgery in otolaryngological field have been used of otomicrosurgery for middle ear operation and recently tend to be used more frepuently for laryngeal surgery. The authors had analyzed 63 cases of laryngeal mass under microsurgery with Suspension Laryngoscope from August '74 to April '79. The results are as follows; 1) The total cases of Suspension Laryngoscope was 63 ; 34 cases (54%) were male and 29 cases (46%) were female. Sex ratio was 1.2 : 1. 2) Age distribution shows 20 cases (37%) in 3rd decide, 10 cases (15.9%) in 4th decade, and 9 cases (14.3%) in 2nd decade. 3) The site of operation was 61 cases (96.8%) from glottic and 2 cases (3.2%) from supraglottic region. 4) The site of glottic region was 24 cases (38.1%) from bilateral, 22 cases (34.9%) from Rt., and 15 cases (14.3%) from Lt. 5) Pathologic findings of biopsy was Laryngeal nodule in 30 cases (47.6%), Squamous cell carcinoma in 10 cases (15.9%), Laryngeal polyp in 8 cases(12.7%), Laryngeal Papilloma in 5 cases (7.9%), and Non-specific inflammation in 5 cases (7.9%).