• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.101-106
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• 2019

Background and Objectives Reinke's edema is a benign vocal fold disease caused by an edematous laryngeal superficial layer of lamina propria. The first line treatment is cessation of smoking and laryngeal microsurgery. The aim of the study is to evaluate the feasibility and efficacy of percutaneous steroid injection via cricothyroid membrane in patients with Reinke's edema. Materials and Method From Jan 2010 to July 2018, 33 Patients with Reinke's edema managed by vocal fold steroid injection via the cricothyroid membrane were included in this study. We compared medical records of laryngoscopy, stroboscopy and Multi-Dimensional Voice Program analysis at pre-treatment and post-treatment. Subjective voice improvement was evaluated using Voice Handicap Index-30 (VHI-30). Results 75.7% of the patients showed partial response and 6.06% showed complete response. 93.94% were present smokers and only 4 patients ceased smoking after the treatment. In acoustic analysis, the pre-treatment mean value of jitter, shimmer, and noise to harmonic ratio was 2.30±3.21, 9.34±10.37, 1.11±2.90 each. The post-treatment value was 2.20±1.89, 6.96±5.30, 0.20±0.09 respectively and none of the parameters were statistically significant. For subjective symptom improvement, 25 (75.8%) patients showed a better score on post-treatment VHI-30 compared to pre-treatment. Conclusion According to our study, steroid injection is a relatively safe and effective procedure for patients with Reinke's edema. A vocal fold steroid injection via the cricothyroid membrane can be an alternative treatment option for those who are not able to undergo conventional laryngeal microscopic surgery, however cessation of smoking is necessary for effective treatment.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.10.1-10
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• 1982

The use of phonosurgery in the recent development of laryngomicrosurgery has enabled the restoration of a normal voice in respect to functional laryngeal surgery which in Korea in the past limited to simple removal of benign laryngeal tumor such as laryngeal polyp or nodules and cordal injection of $Teflon^{{\circledR}}$ for the treatment of recurrent nerve paralysis under the vision of suspension laryngoscopy. Performance of phonosurgery for the treatment of cord paralysis, mutational dysphonia, vocal cord atrophy, hyperkinetic dysphonia and sulcus vocalis is a happy event in the view point of development of phonosurgery in Korea. In this aspect thyroplasty to change the position and physical characteristics of the cord outside the glottis instead of the direct handling of the vocal cord through direct endoscopy is popular. Among the 4 types of thyroplasty, classified by Insshiki(1974), type I thyroplasty(1ateral compression of vocal cord) and type IV thyroplasty(lengthening of vocal cord) were effective in the treatment of unilateral vocal cord paralysis. Advantages of this operation are the fine adjustment of the degree of lateral compression under local anesthesia according to the phonation of the patient during operation and avoidance of dyspnea and intralaryngeal hemorrhage due to the manipulation outside the internal perichondrium of the thyroid cartilage. We did 7 cases of thyroplasty for the treatment of unilateral vocal cord paralysis in the 7 months from September 1981 to March 1982. Before the operation aerodynamic study, psychoacoustical evaluation, stroboscopy and sound spectrographic analysis were done. Two months after the operation the above procedures were performed again. Results of preoperative and postoperative examination were compared and the following results were obtained. 1) In the aerodynamic study, maximum phonation time increased to 158% of the preoperative value and the phonation quotient and the mean flow rate decreased to 58% and 54% of preoperative values. 2) The degree of hoarseness improved in the psychoacoustical evaluation and the glottic chink during phonation was decreased in the stroboscopic examiantion. 3) In the sound spectrographic analysis, periodicity was much restored and noise distribution decreased especially in the high frequency area.

• Speech Sciences
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• v.14 no.2
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• pp.43-53
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• 2007

The purpose of this study was to observe the effect of eating a raw egg by professional or nonprofessional voice users on their voice quality and the duration of the effect. 20 professional voice users and 20 nonprofessional voice users participated in the experiment and they had gone through stroboscopy to have no vocal or laryngeal diseases. The voice exam was performed three times: before eating a raw egg (1st period), right after eating it (2nd period), and 10 minutes later (3rd period). By using Multi-dimensional Voice Program which is a software of Computerized Speech Lab 4500 as a voice analysis instrument, the authors checked the F0, Jitter, Shimmer, Noise to harmonic ratio (NHR), and Voice Range Profile (VRP). Results showed as follows: Firstly, vocal hygiene was good in 57.5% of the total subjects and was poor in 42.5%. 40% of professional voice users and 75% of nonprofessional voice users hand good quality. 77.5% of the total subjects had the vocal fatigue while 22.5% of the subjects did not. 95% of the professional voice users and 60% of nonprofessional voice users complained the vocal fatigue. 60% of the total subjects reported a subjective vocal symptom. 65.0% professional voice users and 70.0% of nonprofessional voice users reported a voice symptom. From the results above, we suggest that eating a raw egg may lead to imporve voice quality of the professional voice users.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.8.2-9
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• 1983

Recently, the laryngomicrosurgery has been done for the removal of benign laryngeal mass and for the improvement of voice. For the evaluation of the effect of the treatment, there must be any objective method such as aerodynamic study, vocal fold vibration study, acoustic analysis, psycho-acoustic evaluation and the neuro-muscular study. The authors evaluated the phoniatric effect of the laryngomicrosurgery for the patients of 15 laryngeal polyps and 9 laryngeal nodules, who received pre-op. and post-op. vocal function study from Jun. 1981 to Mar. 1983. The results obtained were as follows ; 1) The post-op. mean value of the maximum phonation time was increased 40 % in the unilateral polyps, 62 % in the bilateral nodules and 18 % in the unilateral nodules. 2) The post-op. mean value of the phonation quotient was decreased 25 % in comparison with pre-op. value in the case of the bilateral polyps, 26 % in the unilateral polyps, 55 % in the bilateral nodules and 12 % in the unilateral nodules. 3) The post-op. mean value of the mean air flow rate was decreased 27 % in comparison with the pre-op. value in the case of the bilateral polyps, 25 % in the unilateral polyps, 65 % in the bilateral nodules, 25 % in the unilateral nodules. 4) The glottic chink of the 10 cases of polyps among the 11 cases were disappeared, and the glottic chink of the 5 cases of nodules among 7 cases were also disappeared after surgery. 5) The pre-op. hoarseness of the 10 cases of polyps among the pre-op. hoarseness of the 11 cases of polyps were changed to clear and the 3 cases of nodules were also changed to clear.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.118-123
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• 2019

Background and Objectives Voice evaluation is classified into subjective tests such as auditory perception and self-measurement, and objective tests such as acoustic and aerodynamic analysis. When evaluating dysphonia, subjective and objective test results do not always match. The purpose of this study was to analyze the relationship between subjective and objective evaluation in patients with dysphonia and to identify meaningful parameters by disease. Materials and Method The total of 322 patients who visited voice clinic from May 2017 to May 2018 were included in this study. Laryngeal lesions were identified using stroboscopy. Pearson correlation test was performed to analyse correlation between subjective tests including GRBAS scale and voice handicap index, and objective tests including jitter, shimmer, noise to harmonic ratio (NHR), cepstral peak prominence (CPP), maximal phonation time (MPT), mean flow rate, and subglottic pressure. Results In vocal nodule and sulcus vocalis, among GRBAS system, grade and breathiness showed good correlation with CPP, and roughness showed good correlation with jitter or shimmer. In unilateral vocal cord paralysis (UVCP), grade and breathiness showed a very good correlation with CPP, and also good correlation with jitter, shimmer, NHR, and MPT. Also asthenia showed good correlation with CPP and MPT. Vocal polyp has a limited association with other diseases. Conclusion In patients with dysphonia, grade and breathiness showed good correlation with CPP, jitter, and shimmer, and reflect the state of voice change well especially in UVCP, CPP, and MPT.