• Journal of Chest Surgery
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• v.36 no.6
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• pp.439-443
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• 2003

A lower laryngeal and upper tracheal stenosis that is of idiopathic origin is occasionally seen. It is called an idiopathic tracheal stenosis. These circumferential fibrous stenosis is rare and they are most often located in the subglottic larynx and extend to varying distances predominantly in young women. Because of the unknown nature of the disease process and uncertainty about its future progression, patients were approached conservatively. Recently, surgical resection and reconstruction have been increasingly performed, as favorable results were obtained. Three female patients with dyspnea were admitted. For two patients, they were diagnosed this conditions as bronchial asthma by mistake. All patients were performed computed tomography and bronchoscopy. For two patients with subglottic stenosis, subglottic resection was performed by cervical collar incision, and for the other one patient with distal tracheal stenosis, tracheal resection was performed by right posterolateral thoracotomy. A diagnosis of idipathic tracheal stenosis was confirmed by postoperatively pathologic finding. For one case, because of anastomosis site infection and restenosis, a whole tracheal exposure was performed by cervical collar incision and median sternotomy. And reoperation was peformed successfully.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.114-121
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• 2016

Background and Objectives : Many students major in applied music singing have various difficulties in phonation when they sing or perform. But the studies about this cause are lack. The purpose of this study is whether singing voice therapy based on vocal music is effective or not to applied music singing students that have difficulties in phonation. Materials and Methods : Singing voice therapy program had been done to 8 students major in applied music singing during 7 weeks. We did laryngeal stroboscope, perceptual, acoustic and aerodynamic examination before and after singing voice therapy to this students. And we studied post examination results have differences or improvements compared to pre examination results. Results : Four male students don't have effective improvement after singing voice therapy but they shows slight improvement in aerodynamic examination values compared to pre examination values. Four female students shows improvement in aerodynamic examination values and pitch range increasing. Above all, one student's vocal nodules disappeared after singing voice therapy. Conclusion : Singing voice therapy based on music singing is very effective to the students major in applied music singing. Above all, their curriculum in applied music singing should include phonation training based on music singing before training perform and technic practices.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.2
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• pp.100-105
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• 2017

Background and Objectives : Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. Materials and Methods : From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. Results : Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p<0.01). Well defined formants were not found different between two groups. Conclusion : The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.

• Korean Journal of Head & Neck Oncology
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• v.13 no.2
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• pp.213-220
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• 1997

Background: Thyroid cancer is a relatively rare neoplasm and its incidence varies geographically and ethnically around the world. Thyroid cancer is the most common endocrine malignancy, but it has a wide spectrum of biologic behavior, histologic appearance, and management. Purpose: The purpose of the study was to analyse and evaluate all aspects of the clinical consideration in thyroid cancer. Method: Between 1986 and 1995, a retrospective analysis of 77 thyrod cancer patients admitted at the Department of Surgery, Hangang Sacred Heart Hospital, Hallym University was made to assess clinical entities. Result: By the pathological classification, the papillary carcinoma was the most common type(83.1%). Male to female ratio was 1 : 5.4 and most prevalent age group was noted from fourth decade to fifth decade(46.8%). The most common duration of illness between the appearance of the symptoms and the treatment was below 6 months(44.2%), and the most common symptom was the palpable mass at the anterior portion of the neck(96.1%). Most cases of the thyroid cancer were appeared as cold nodule in the $^{99m}$Tc-thyroid scan(95.7%). In the site of tumor location, the right and left lobe was distributed similarly. In the extent of tumor, incidence of intrathyroidal location was 41.6%, and that of the metastasis to the cervical lymph nodes was 44.2% and that of the direct capsular invasion was 27.3%, and incidence of both involved case was 13%. Surgical procedures were total thyroidectomy alone in 27 cases(35.1%) or with modified neck dissection in 6 cases(7.8%), or with radical neck dissection in 2 cases (2.6%), near total thyroidectomy alone in 22 cases(28.6%), ipsilateral lobectomy with isthmectomy alone in 12 cases(15.6%) or with modified neck dissection in 1 case(1.3%), and biopsy only in 7 cases(9.1%). The most common postoperative complications were transient hypoparathyroidism(5.2%) and transient unilateral recurrent laryngeal nerve paralysis(5.2%). Conclusion: The major problem of management of thyroid cancer include a wide spectrum of clinical behaviour of this tumor entity, the lack of reliable prognostic factors and lack of an objective assessment of the various treatment modalities. But because of showing the favorable prognosis for most thyroid cancer, appropriate and aggressive management should be recommended.

• Journal of Chest Surgery
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• v.31 no.1
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• pp.40-45
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• 1998

Recently, video-assisted thoracoscopic surgery for mediastinal lesions has been considered a new effective therapeutic method. From March, 1992 to April, 1997, 33 cases of video assisted thoracoscopic surgery for mediastinal lesions were performed. Gender distribution was 16 males and 17 females. Average age was 42 years old(ranged from 14 to 69). The locations of lesions were anterior mediastinum in 14 cases, middle mediastinum in 5 cases, posterior mediastinum in 11 cases, and superior mediastinum in 3 cases. These included 9 neurilemmomas, 5 benign cystic teratoma, 4 pericardial cysts, 2 ganglioneuroma, 2 thymus, 2 thymic cyst, 1 thymoma, 2 esophageal leiomyomas, 1 dermoid cyst, 1 lipoma, 1 malignant lymphoma, 1 bronchogenic cyst, 1 pericardial effusion, and 1 Boerhaave's disease with empyema. Working window was needed in 6 cases. We converted to open thoracotomy in 6 cases. Reasons of convertion to open thoracotomy were large sized mass(1), severe adhesion(3), and difficult location to approach(2). The average operation time was 116min($\pm$56 min). The average chest tube drainage time was 4.7days. The average hospital stay was 8.7 days. Operative complications were atelectasis(2), empyema with mediastinitis(1), recurrent laryngeal nerve palsy(1), and plenic nerve palsy(1). In conclusion, VATS for mediastinal lesions were performed with shorter operation time and hospital stay, and lesser complications and pain than those of conventional thoracotomy.

• 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.

• Korean Journal of Head & Neck Oncology
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• v.1 no.1
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• pp.87-94
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• 1985

A total of eighty five cases with supraglottic carcinoma treated by radical radiotherapy in Yonsei Cancer Center between Jan. 1974 and Dec. 1980, was observed through retrospective analysis. This study is concerned wi th patients selection for irradiation alone or combined treatment with surgery. Emphasis is directed to the analysis of effectiveness of radical radiotherapy instead of partial laryngectomy in T-1, T-2 and early T-3 lesion. A satisfactory control of laryngeal disease and preservation of a normal voice ranging from 100% for $T_1N_0$ lesions, 61.1% for $T_2N_0$ to 50% for $T_3N_0$. But 47.1% of cases with node metastasis on admission had poor results to irradiation suggesting of necessicity of combined treatment. 5 year recurrence-free survivals was 43.3% in all cases with supraglottic carcinoma treated by irradiation alone, although it was 87.5% in T-1 and 51.8% in T-2.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.52-54
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• 2004

Hemangioma of the larynx is generally classified into adult and infantile form. More common infantile form usually arises on subglottic portiion and may cause respiratory distress. Adult form is rare and arises on vocal cord or above. Vocal cord hemangioma was rarely reported in the medical literature. Since Kimmelman et al reported vocal hemangioma in 1979 first, there are four cases of vocal hemangioma reported in medical literature. Recently, we experienced a case of vocal cord hemangioma and successfully removed it with micro-laryngeal surgery. Hence we report this case with review of literatures.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.78-83
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• 2016

Laryngopharyngeal reflux (LPR) disease is an extraoesophageal variant of gastro-esophageal reflux disease that can affect the larynx and pharynx. LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

• The Korean Journal of Emergency Medical Services
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• v.9 no.1
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• pp.95-99
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• 2005

Penetrating neck trauma by gunshot injury involving tracheobronchial tree is rare in Korea. Extensive tissue damage by cavitation, tissue fragmentation and shock wave transmission of high-velocity projectile along with associated organ injury renders high rate of mortality and morbidity. A 28 year old man in military service with gunshot wound in left cervical area presented initial symptoms of severe dyspnea and subcutaneous emphysema. Computed tomography of chest and cervical region as well as bronchoscopic evaluation was performed to confirm highly suspected injury to cervical trachea. Surgical exposure was established through a low collar incision; the damaged segment of 3.5 cm length including 2-4th tracheal rings was resected out and end-to-end anastomosis was performed. Bleeding from lacerated anterior jugular vein was controlled by ligation of both ends and a K2 bulllet was found upon inner border of body of first rib, medial to right carotid sheath and removed out. Cervical esophagus, carotid artery, internal jugular vein and recurrent laryngeal nerve were spared. Extubation was done on the first postoperative day and postoperative course until discharge on nineth postoperative day remained uneventful.