• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.95-100
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• 2019

Background and Objectives For patients with polyps and cysts, glottal gaps resulting from their lesions have negative respiratory effects when they vocalize. Phonatory Aerodynamic System is clinically used, but is often limited in the measurement of vowels. So the researchers attempted to verify the usefulness of Phonatory Aerodynamic System by comparing differences in respiratory characteristics and patterns which can be measured by the level of connected speech. Materials and Method Among the subjects who were diagnosed through a stroboscopy, there were 33 patients with polyps and 23 patients with cysts. Then, 36 subjects who were found to have no specific findings through a stroboscopy and perceptual test were selected to the normal group. We compared respiratory characteristics and patterns. And compared vocal polyps and cysts before and after laryngeal micro surgery (LMS). Results First, difference in respiratory patterns between the normal group and the patients with polyps and cysts were examined to show that breath groups, breath group syllables, and expiratory·inspiratory volume were significantly higher in the polyp/cyst group than those in the normal group, indicating that precision was lowered during the conversation, due to reduction in speech intelligibility and interruption of communication. Second, there were significant differences in maximum phonation time, mean flow rate, and subglottal pressure among respiratory characteristics, breath groups, breath group syllables, and inspiratory volume before and after LMS, which appeared to be similar to the normal group. Conclusion The understanding of respiratory characteristics and patterns produced by patients in connected speech which is most similar to natural speech was found to be the objective and useful method for examining characteristics of the subjects.

• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.158-166
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• 1995

Planning of the skin incision is one of the most important point for safe removal of the head and neck cancer. The fact that so many types of incisions exist is strong testimony that there is hardly one incision that fits all situation. Factors that influence the choice are adequate exposure, changeability to other types of neck dissection, optimal exposure of the primary site and/or opposite side of the neck, and safety of the neck flap and cosmesis. Laryngeal and hypopharyngeal carcinomas are the most common tumor of the head and neck, even though there are so many diverse situation exist, there must be an optimal approach to each case. From 1992 to 1994 surgical approaches used for laryngeal and hypopharyngeal carcinoma at the Severance Hospital were reviewed. Types of surgical approaches, its pitfall, advantage and disadvantages were reviewed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.122-125
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• 2016

Although many factors associated with difficult intubation have been known, predictors of difficult mask ventilation are not well known. We experienced a case of nearly complete airway obstruction following usual anesthetic induction which needed various emergency treatments. The patient had a preoperative diagnosis of contact granuloma of right posterior vocal cord and bilateral vocal cord palsy but later was found out as invasive laryngeal cancer. Upon the surgical field of view, both vocal cords were showing significantly thickened and fixated appearance and was considered as in the critical narrowing state with the potential of complete obstruction. Using $C-MAC^{(R)}$ video laryngoscope we were able to see the narrowed vocal cord and choose proper size of endo-tracheal tube. Consequently, intubation was successfully done and operation was conducted. From this case, we have lessons that physicians should examine the patient's airway more carefully in case of laryngeal mass and prepare emergency measures.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.2-14
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• 1983

Complications and sequelae of the laryngeal trauma are respiratory difficulties, edema or swelling, cellulitis or abscess, fistula, perichondrium and chondritis, chronic laryngeal stenosis, vocal cord paralysis, decannulation difficulty, and impaired voice production etc. Generally, the treatment of laryngeal injuries consists of initial tracheostomy for adequate airway and later surgical intervention for its complications and sequelae. Recently, authors experienced a case of closed laryngeal injury with thyroid cartilage fracture, left vocal cord paralysis, swallowing difficulty and right clavicular fracture owing to automobile accident. With reconstructive surgery for thyroid cartilage fracture, we established an adequate airway, improved swallowing function and better voice production.

• Journal of Biomedical Engineering Research
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• v.43 no.2
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• pp.102-108
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• 2022

Purpose: To propose a deep learning-based clinical decision support technique for laryngeal disease on epiglottis, tongue and vocal cords. Materials and Methods: A total of 873 laryngeal endoscopic images were acquired from the PACS database of Pusan N ational University Yangsan Hospital. and VGG16 model was applied with transfer learning and fine-tuning. Results: The values of precision, recall, accuracy and F1-score for test dataset were 0.94, 0.97, 0.95 and 0.95 for epiglottis images, 0.91, 1.00, 0.95 and 0.95 for tongue images, and 0.90, 0.64, 0.73 and 0.75 for vocal cord images, respectively. Conclusion: Experimental results demonstrated that the proposed model have a potential as a tool for decision-supporting of otolaryngologist during manual inspection of laryngeal endoscopic images.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5439-5444
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• 2012

Objective: To explore the correlation of human papillomavious (HPV) infection with expression of p53 and proliferating cell nuclear antigen (PCNA) in patients with different ethnicity in Xinjiang, China. Methods: 166 biopsy specimens from 83 laryngeal squamous cell carcinomas (LSCC), 63 laryngeal papillomas (LP), and 20 laryngeal inflammatory polyps (LIP) were included in this study. HPV infection was determined by polymerase chain reaction (PCR) using specific types of HPV primers. Expression of p53 and PCNA was assessed using immunohistostaining. Results: The frequency of HPV 6/11 was higher in LP (33.3%) than in LSCC (9.6%) (P<0.0005), whereas the frequency of HPV 16/18 was higher in LSCC (37.3 %) than in LP (6.3%) (P<0.0005). Patients of the Han ethnic group with LSCC had a higher infection rate with HPV 6/11 or HPV 6/11 and HPV 16/18 coinfection than those of Uygur and Kazak ethnicity (P<0.05). Overexpression of p53 and PCNA were higher in LSCC (62.7%, 57.8%) than in LP (38%, 33.3%) (P<0.005, and P<0.005, respectively). That of p53 was not associated with lymph-node metastases and clinical stages, but overexpression of PCNA closely correlated with clinical stage. Conclusions: These results strongly implicate HPV6/11 infection in the carcinogenesis of LSCC and LP, respectively. There was a higher coincidence of increased malignancy of laryngeal tumors with overexpression of p53 and PCNA. Overexpression of p53 may serve as an early risk marker for malignant transformation in HPV infected cells while the overexpression of PCNA may serve as a late marker for progression of LSCC.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.27-34
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• 1998

Objectives, Materials & Methods: To prevent deterioration of postoperative voice due to iatrogenic transection of the recurrent laryngeal nerve during the thyroid surgery, intraoperative medialization of the membranous vocal cord by type I thyroplasty together with direct epineurial neurorraphy was done on 2 cases of benign thyroid lesion. To improve the quality of voice together with complete removal of advanced thyroid carcinoma, intraoperative vocal cord medialization on the lesion side together with total thyroidectomy was done by type I thyroplasty in 2 cases and combined procedure by arytenoid adduction and type I thyroplasty in another 2 cases. Results: The resultant voice of the iatrogenic injury cases was relatively tolerable. The voice of the combined procedure was better than that of type I thyroplasty cases for the intraoperative rehabilitation cases. Not only for the preoperative evaluation of the severity of the nerve lesion but also the prognosis will be expected by use of laryngeal EMG in the cases of thyroid cacer with vocal cord palsy. Conclusion: Intraoperative simultaneous rehabilitation for the vocal cord palsy during thyroid surgery is beneficial for the patients.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.105-105
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• 1993

Laryngeal cancer is the commonest of all head and neck malignancies and, in Korea, constitutes approximately 2.3% of all malignancies among males. Survival rate is rather higher than any other head and neck malignancies. Treatment results of 121 laryngeal cancer patients were analyzed. 1. Glottic region 44%, supraglottic 41%, subglottic 8%, transglottic 7%. 2. Rate of cervical metastasis according to T stage was 19% in T2 stage, 47% in T3 stage, 69% in T4 stage. 3. Overall 3-year NED survival rate was 65% and showed stage I 93%, stage II 76%, stage III 63%, stage IV 53%. 4. Glottic cancer showed much better prognosis(3-year NED 82%) than supraglottic cancer(3-year NED 58 %). 5. According to treatment modality, complication rates in surgery with postoperative radiation was higher than in surgery along and disproportionally higher in salvage surgery after failed curative radiation.

• International journal of thyroidology
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• v.11 no.2
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• pp.130-136
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• 2018

Background and Objectives: Intraoperative neural monitoring (IONM) of recurrent laryngeal nerve (RLN) in thyroid surgery has been employed worldwide to identify and preserve the nerve as an adjunct to visual identification. The aims of this study was to evaluate the efficacy of IONM and difficulties in the learning curve. Materials and Methods: We studied 63 patients who underwent thyroidectomy with IONM during last 2 years. The standard IONM procedure was performed using NIM 3.0 or C2 Nerve Monitoring System. Patients were divided into two chronological groups based on the success rate of IONM (33 cases in the early period and 30 cases in the late period), and the outcomes were compared between the two groups. Results: Of 63 patients, 32 underwent total thyroidectomy and 31 thyroid lobectomy. Failure of IONM occurred in 9 cases: 8 cases in the early period and 1 case in the late period. Loss of signal occurred in 8 nerves of 82 nerves at risk. The positive predictive value increased from 16.7% in the early period to 50% in the late period. The mean amplitude of the late period was higher than that of the early period (p<0.001). Conclusion: IONM in thyroid surgery is effective to preserve the RLN and to predict postoperative nerve function. However, failure of IONM and high false positive rate can occur in the learning curve, and the learning curve was about 30 cases based on the results of this study.

• 대한핵의학회:학술대회논문집
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• 2005.11a
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• pp.345.2-345.2
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• 2005