• 제목/요약/키워드: Laryngeal surgery

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성대 용종 환자의 후두미세수술 전후 음성 평가에서 OperaVOXTM와 Multi-Dimensional Voice Program 간의 신뢰도 연구 (Reliability of OperaVOXTM against Multi-Dimensional Voice Program to Assess Voice Quality before and after Laryngeal Microsurgery in Patient with Vocal Polyp)

  • 김선우;김소연;조재경;진성민;이상혁
    • 대한후두음성언어의학회지
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    • 제31권2호
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    • pp.71-77
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    • 2020
  • Background and Objectives OperaVOXTM (Oxford Wave Research Ltd.) is a portable voice analysis software package designed for use with iOS devices. As a relatively cheap, portable and easily accessible form of acoustic analysis, OperaVOXTM may be more clinically useful than laboratory-based software in many situations. The aim of this study was to evaluate the agreement between OperaVOXTM and Multi-Dimensional Voice Program (MDVP; Computerized Speech Lab) to assess voice quality before and after laryngeal microsurgery in patient with vocal polyp. Materials and Method Twenty patients who had undergone laryngeal microsurgery for vocal polyp were enrolled in this study. Preoperative and postoperative voices were assessed by acoustic analysis using MDVP and OperaVOXTM. A five-seconds recording of vowel /a/ was used to measure fundamental frequency (F0), jitter, shimmer and noise-to-harmonic ratio (NHR). Results Several acoustic parameters of MDVP and OperaVOXTM related to short-term variability showed significant improvement. While pre-operative value of F0, jitter, shimmer, NHR was 155.75 Hz (male: 125.37 Hz, female: 183.37 Hz), 2.20%, 6.28%, 0.16, post-operative values of these parameter was 164.34 Hz (male: 129.42 Hz, female: 199.26 Hz), 2.15%, 5.18%, 0.14 Hz in MDVP. While pre-operative value of F0, jitter, shimmer, NHR was 168.26 Hz (male: 135.16 Hz, female: 201.37 Hz), 2.27%, 6.95%, 0.26, post-operative values of these parameters was 162.72 Hz (male: 128.267 Hz, female: 197.18 Hz), 1.71%, 5.36%, 0.20 in OperaVOXTM. There was high intersoftware agreement for F0, jitter, shimmer with intraclass correlation coefficient. Conclusion Our results showed that the short-term variability of acoustic parameters in both MDVP and OperaVOXTM were useful for the objective assessment of voice quality in patients who received laryngeal microsurgery. OperaVOXTM is comparable to MDVP and has high intersoftware reliability with MDVP in measuring the F0, jitter, and shimmer

후두유두종증의 예후인자: 20년간의 임상 경험을 통한 분석 (Prognostic Factor of Laryngeal Papillomatosis: 20 Years Experience)

  • 정은재;홍석진;조재구;백승국;우정수;권순영;정광윤
    • 대한기관식도과학회지
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    • 제16권2호
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    • pp.145-148
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    • 2010
  • Background: Laryngeal papillomatosis, which is cased by human papillomavirus, is the most common benign neoplasm of the larynx. However, the prognosis of this disease remains really unpredictable. The aim of this paper is to determine whether any clinical features at the time of diagnosis could predict its course. Material and Method: Eighty-six patients treated at our institution during the last 20 years were analyzed retrospectively. All patients had microsurgery under general anesthesia. All patients' follow-up period was more than 1 year. We divided the patients into 1) Juvenile versus adult group based on their age 20, 2) single surgical method with laser versus dual surgical method with laser and microdebrider group, and 3) single subsite versus multiple subsites group. And we compared the therapeutic outcome. Results: The recurrence rate was 100% (15 patients) in the JP group and 56% (40 patients) in the AP group. Juvenile versus adult group was the only independent prognostic factor by univariate, and multivariate analysis. Microdebrider resection technique and multiple subsites were not associated with treatment result. Time period from the first surgery to recurrence detection was different statistically only for the age group. The number of surgery in the JP group ranged from 1 to 31 (mean 8.8). In the AP group the number of surgery ranged from 1 to 25 (mean 3.7). It was statistically different. Conclusion: Prognosis for the laryngeal papillomatosis remains unpredictable. Only patients' age was the only independent prognostic factor.

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Change of Voice Parameters After Thyroidectomy Without Apparent Injury to the Recurrent Laryngeal or External Branch of Superior Laryngeal Nerve: A Prospective Cohort Study

  • Lee, Doh Young;Choe, Goun;Park, Hanaro;Han, Sungjun;Park, Sung Joon;Kim, Seong Dong;Kim, Bo Hae;Jin, Young Ju;Lee, Kyu Eun;Park, Young Joo;Kwon, Tack-Kyun
    • 대한후두음성언어의학회지
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    • 제33권2호
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    • pp.89-96
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    • 2022
  • Background and Objectives The quality of life after thyroidectomy, such as voice change, is considered to be as important as control of the disease. In this study, we aimed to evaluate changes in both subjective and objective voice parameters after thyroidectomy resulting in normal morbidity of the vocal cords. Materials and Method In this prospective cohort study, 204 patients who underwent thyroidectomy with or without central neck dissection at a single referral center from Feb 2015 to Aug 2016 were enrolled. All patients underwent prospective voice evaluations including both subjective and objective assessments preoperatively and then at 2 weeks, 3, 6, and 12 months postoperatively. Temporal changes of the voice parameters were analyzed. Results Values of the subjective assessment tool worsened during the early postoperative follow-up period and did not recover to the preoperative values at 12 months postoperatively. The maximal phonation time gradually decreased, whereas most objective parameters, including maximal vocal pitch (MVP), reached preoperative values at 3-6 months postoperatively. The initial decrease in MVP was significantly greater in patients undergoing total thyroidectomy, and their MVP recovery time was faster than that of patients undergoing lobectomy (p=0.001). Patients whose external branch of the superior laryngeal nerve was confirmed intact by electroidentification showed no difference in recovery speed compared with patients without electroindentification (p=0.102), although the initial decrease in MVP was lower with electroidentification. Conclusion Subjective assessment in voice quality and maximal phonation time after thyroidectomy did not show recovery to preoperative values. Aggravation of MVP was associated with surgical extent and electroidentification.

후두재발암에 있어서 식도위문합술을 이용한 식도재건술의 치험 1례 (A Case of Esophageal Reconstruction with Gastric Transposition in a Recurrent Laryngeal Carcinoma)

  • 홍원표;김형옥;김경수;김충배;탁관철
    • 대한두경부종양학회지
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    • 제4권1호
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    • pp.35-40
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    • 1988
  • A transhiatal esophagectomy without thoracotomy and esophageal reconstruction with gastric transponsition was performed in a recurrent laryngeal carcinoma spread to cervical esophagus. There were several benefits to performing this method: 1) It could be performed in one stage, took shorter operating time, and provided safe and efficient palliation in the patient with esophageal carcinoma. 2) The possible maximum surgical margin was obtained and the incidence of suture line tumor recurrence was minimized. 3) Postoperative death from anastomotic disruption and secondary mediastinitis and sepsis were virtually eliminated. 4) Clinically significant gastroesophageal reflux rarely occured.

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후두기능 진단을 위한 음성 및 유체역학적 측정장치 개발 (Speech and Aerodynamics Measurement System for Laryngeal Function Assessment)

  • 이재성;박광석;성명훈;김광현
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1996년도 추계학술대회
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    • pp.37-39
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    • 1996
  • For the laryngeal function assessment, we developed a measurement system of speech sound and air flow rate. The speech sound was transduced with a standard omnidirectional condenser microphone and orally emitted air flow was measured with pneumotachometer using differential pressure transducer.

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외상후 발생한 성문하후두의 완전절단 치험 1례 (Subglottic transection of larynx with right pneumothorax One case Report)

  • 김학제
    • Journal of Chest Surgery
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    • 제18권4호
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    • pp.812-816
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    • 1985
  • In the past several years the popularity of the motor cycle has produced an increasing incidence of the injuries to the larynx and trachea. Most of all on accidents come to death and survivors to the hospital are rare. Early diagnosis and to keep air way are necessary to initiate proper treatment in injury of upper air way. Meticulous apposition of mucous membrane and reconstitution of laryngeal skeleton are important. We experienced a rare case of 26 year old men with cricothyroidal transection after trauma. On Oct. 17, 1985, the patient struck his neck on baggage frame of truck when dropping from his motor cycle on sudden stop. Emergency tracheal intubation on distal segment of trachea was accomplished by otolaryngologist in a local clinic. He was transferred to our hospital. Exploration 2 hours later revealed complete separation of cricoid cartilage from thyroid cartilage. The recurrent laryngeal nerve could not be identified. Anastomosis of thyroid and cricoid was accomplished and Portex endotracheal tube was inserted as splint for 10 days. No stenosis developed. The air way appeared adequate for moderate physical activity though paramedian fixation of vocal cord paralysis. Postoperative follow-up course has been good after he discharged on POD 14 days.

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급성 호흡곤란이 발생한 성문암 환자에서 기도 확보를 위한 고유량 비강 캐뉼라 보조 기관절개술 (High Flow Nasal Cannula Assisted Tracheostomy for Securing Airways in Patients with Acute Respiratory Distress Induced by Glottic Cancer)

  • 홍승우;이동근
    • 대한후두음성언어의학회지
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    • 제31권1호
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    • pp.31-34
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    • 2020
  • Tracheostomy is considered as a first treatment, when oral intubation seems to be difficult in patient who present severe upper airway obstruction. Generally, tracheostomy is performed in supine position. But if airway obstruction is severe enough to cause dyspnea, low oxygen saturation and inability to maintain supine position, tracheostomy should be performed in sitting position. The authors report a case of successful tracheostomy using high flow nasal cannula which help to maintain stable oxygen saturation and respiration in patients with laryngeal cancer.

Flexible laryngeal mask airway management for dental treatment cases associated with difficult intubation

  • Tsukamoto, Masanori;Hitosugi, Takashi;Yokoyama, Takeshi
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제17권1호
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    • pp.61-64
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    • 2017
  • Nasotracheal intubation is generally a useful maxillofacial surgery that provides good surgical access for intraoral procedures. When nasotracheal intubation is difficult, laryngeal mask airway (LMA) insertion can be performed, and the flexible $LMA^{TM}$ (FLMA) is also useful for anesthetic management. However, the FLMA provides limited access to the mouth, which restricts the insertion of instrumentation and confines the surgical field available. Here, we present our experience using the FLMA airway management for dental treatment cases involving difficulty with intubation.

술 후 재발한 염증성 성대 병변의 임상 양상 (Clinical Analysis of Recurrence in Inflammatory Laryngeal Disease after Laryngomicrosurgery)

  • 김영선;김진호;박문규;유홍균;오준환;최종욱
    • 대한후두음성언어의학회지
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    • 제11권1호
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    • pp.28-31
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    • 2000
  • Microscopic surgery of the larynx normally have a low recurrence rate. However, once they do recur, it is uneasy to manage recurrent diseases. Recurrence is often the result of inappropriate postoperative care and voice management. Out of the 764 patients operated for benign inflammatory laryngeal diseases, we have conducted a clinical analysis of 54 cases who have had at least one episode of recurrence after the initial treatment with laryngomicrosurgery (7.1% of recurrence rate). High risk groups for recurrence were determined, and they were related to cigarette smoking, alcohol intake, laryngopharyngeal reflux. From our experience and literature review, we conclude that pre- and postoperative patient education concerning these risk factors and voice usage Is of critical need to prevent recurrence of inflammatory laryngeal lesions after laryngomicrosurgery.

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