The clinical study of 108 laryngeal mass was observed in our E.N.T. department, and classified clinically and pathologically as below. 1) Among total case of 108 Vocal nodule is 28 (26 %) Vocal polyp is 46 (42.5 %) Laryngeal papilloma is 6 (5.5 %) Laryngeal tuberculosis is 4 (4%) Laryngeal cancer is 24 (22%) 2) The sex ratio of male to female is 5 : 7 in vocal nodule 11 : 12 in vocal polyp 1 : 1 in laryngeal papilloma 3 : 1 in laryngeal tuberculosis 5 : 1 in laryngeal cancer 3) The age distribution is fourth, fifth decade in vocal nodule is fifth, fourth decade in vocal polyp is first decade in laryngeal papilloma is third and seventh decade in laryngeal tuberculosis is sixth and seventh decade in laryngeal cancer 4) The location of mass is between the anterior 1/3 and middle 1/3 of vocal cord in vocal nodule, polyp and papilloma middle 1/3 and posterior 1/3 in laryngeal tuberculosis and glottic (50%), supraglottic (42%), infraglottic (8%) in laryngeal cancer 5) The side of lesion is bilateral in vocal nodule and papilloma, the ratio of right to left is 2 : 3 in vocal polyp 6) The size is 1-2mm in vocal nodule and papilloma, 3-5mm in vocal polyp more than 10mm in laryngeal tuberculosis and laryngeal cancer 7) The duration of symptom is within 1 years in vocal nodule and vocal polyp and laryngeal papilloma, 1-several years in laryngeal tuberculosis and laryngeal cancer 8) The most frequent symptom was hoarseness 9) All laryngeal cancer was sguamous cell carcinoma
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
/
v.20
no.1
/
pp.25-30
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2009
Introduction: 585 nm Pulsed dye laser (PDL) laryngeal surgery is based on the photodynamic characteristics of selective photothermolysis and photoangiolysis and recently considered to be the treatment for a variety of benign laryngeal disease. Objective: To review the indications and outcome of office-based 585nm PDL surgery and summarize new developments. Method: Retrospective study involving 402 patients was performed, The PDL surgery could be applied to various laryngeal diseases such as laryngeal papilloma, vocal fold dysplasia, laryngeal granuloma, vocal polyp, capillarectasia, scarred vocal fold and sulcus vocalis. Results : The physiologic properties of the vascular specificity of PDL provide many advantages and appear to be effective for laryngeal treatment. The PDL resulted in precise, selective coagulation of the microvasculature without damage to the surrounding tissue. Therefore PDL surgery is safe and effective for office-based treatment of benign laryngeal disease and for all patients regardless of their overall medical condition. Conclusion: PDL surgery provides potential benefits and advantage for treating common benign laryngeal disease.
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.
Background: Laryngeal paralysis is a common idiopathic degenerative neurological disease in older medium-to-large breed dogs, with surgical correction of the obstruction being the treatment of choice. Objectives: This study evaluated the use of laryngeal silicone stents to treat canine laryngeal paralysis in dogs where classic surgical treatment was not accepted by the owners. Methods: Dogs diagnosed with laryngeal paralysis, for which the owners refused arytenoid lateralization surgery as a first-line treatment, were treated with laryngeal silicone stents. Results: Six dogs with bilateral laryngeal paralysis were included in the study. All dogs showed improvement in clinical signs immediately after the procedure. No clinical signs or radiographic changes were noted in four out of six dogs in the follow-up visit performed 1 wk later. One dog was suspected of aspirating water while drinking, but the signs disappeared after repositioning the stent. Another dog had a relapse of stridor due to caudal migration of the stent. This dog underwent arytenoid lateralization surgery because larger stents are not commercially available. At the time of writing, between seven and 13 mon after stent placement, no significant incidents have occurred in four dogs, and all owners report a satisfactory quality of life. Conclusions: Laryngeal silicone stenting is an interesting alternative for treating dogs with acquired laryngeal paralysis when the owners refuse classic arytenoid lateralization surgery. Furthermore, stent placement can be a temporary solution to stabilize these dogs until a permanent surgical treatment can be performed.
Background: Laryngeal malignancy is a common malignancy of the head and neck region. Affected patients usually present with features that are characteristic of certain subsites. The larynx is oncologically divided into three: supraglottis, glottis and subglottis. Studies from Western countries have shown that the glottis is the commonest subsite to harbour laryngeal malignancy. However, the supraglottis has been reported to be the commonest subsite in developing countries, including examples in the Indian subcontinent. To our knowledge, no study has been carried out in western Nepal about the epidemiology of laryngeal cancer to date. The purpose of this study was to analyse the epidemiology of laryngeal cancer in relation to its risk factors, age distribution,and preferred subsites and to see if there is any recent change in the subsite wise distribution of laryngeal malignancy in western Nepal. Materials and Methods: Patients of all ages and both sexes with suspected laryngeal malignancy were enrolled in the initial study. Detailed history taking and clinical examination was performed to find out the involved subsite in relation to the clinical features. Direct laryngoscopy was performed to further confirm the subsite and to take biopsy from the growth under general anesthesia. After confirmation of malignancy from the biopsy report, patients were finally included in the study. Data were analysed and observations were made to find out the distribution of laryngeal malignancy in different subsites. Results: The supraglottic larynx was the commonest subsite to harbor laryngeal malignancy. Smoking and alcohol were found to be the common risk factors. The mean age of the patients was in their sixties. Conclusions: Laryngeal malignancy is common in elderly individuals. Supraglottic laryngeal malignancy is the commonest laryngeal malignancy in people who smoke and drink alcohol in Nepal. Avoidance of alcohol use and smoking will be a milestone to reduce the incidence of laryngeal cancers and associated mortality.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.19
no.1
/
pp.43-46
/
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.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.14
no.2
/
pp.110-116
/
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.
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.12
no.1
/
pp.11-16
/
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.
Objective: To investigate the correlation between extracellular matrix protein-1 (ECM1) and the growth, metastasis and angiogenesis of laryngeal carcinoma. Materials and Methods: Forty-five samples with laryngeal benign and malignant tumors confirmed by pathology in Laiwu City People's Hospital from March 2006 to March 2011 were collected, in which there were 29 cases with laryngeal carcinoma and 16 with benign tumors. The expression of ECM1 and factor VIII-related antigens in patients with laryngeal carcinoma and those with benign tumors was respectively detected using immunohistochemical method, and the correlation between ECM1 staining grade and microvessel density (MVD) was analyzed. Results: In laryngeal carcinoma tissue, ECM1 was mainly expressed in cytoplasm, less in cytomembrane or intercellular substance. With abundant expression in the tissue of laryngeal benign tumors (benign mesenchymoma and hemangioma), ECM1 was primarily expressed in the connective tissue, which was different from the expression in laryngeal carcinoma tissue. The proportion of positive ECM1 staining (++) in patients with laryngeal carcinoma was dramatically higher than those with benign tumors (p<0.05), and that of strongly-positive ECM1 staining (+++) slightly higher. The results of Spearman nonparametric correlation analysis revealed that ECM1 staining grade in laryngeal carcinoma tissue had a significantly-positive correlation with MVD (r=0.866, p=0.000). Conclusions: ECM1 expression in laryngeal carcinoma is closely associated with tumor cell growth, metastasis and angiogenesis, which can be considered as an effective predictor in the occurrence and postoperative recurrence of laryngeal carcinoma.
Background and Objectives: Total laryngectomy is often required for advanced cases. But this operation induced the many inconvenience of basic daily life. Early diagnosis of laryngeal cancer is very important to prevent from this disastrous condition. In this point of view, mass screening test for early detection of laryngeal cancer is necessary. Screening test using voice has many advantages such as simple, less interventional. Voice collection by Automatic Response System(ARS) is comfortable and easy to got acoustic sample. Thus author tried to got the acoustic parameters which can differentiate normal, benign. and malignant laryngeal diseases and also checked the availability of parameters on neural network system. Materials and Methods: Author has evaluated the voice from 17 laryngeal cancer patients and 45 benign laryngeal disease patients who visited at Department of Otolaryngology, Pusan National University Hospital from May 1998 to April 2001, and 15 normal control. Author chose the sir Parameters (Jitt. vFo, Shim, vAm, NHR, SPI) that was thought to be related with voice collected by ARS among thirty-three parameters analysed by a Multi-Dimensional Voice Program (MDVP). Two-step neural network was used for the availability of six parameters. Results: The detection rate of normal voice by ARS voice analysis is 78.5% and detection rate of abnormal voice was 97.1 o/o. Among abnormal voice, the detection rate of benign laryngeal diseases and laryngeal cancers were 82.4 o/o, 70.6% respectively. Conclusion: Author concluded that six parameters and Matlab based neural network software may be effective in development of acoustic screening system for laryngeal cancer and further study should be necessary for development of new acoustic parameters.
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