• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.132-135
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• 2019

Spasmodic dysphonia is a focal laryngeal dystonia that results in involuntary spasms during speech. The etiology of spasmodic dysphonia is not yet defined, but it is presumed to be a neurological abnormality of central nervous system motor function. The treatment of choice for spasmodic dysphonia is botulinum toxin injection directly at the laryngeal muscles. However botulinum toxin injection requires repeated procedures. Many different kinds of surgical treatments have been introduced but the recurrence rate is still high. So we performed myomectomy with LASER and neurectomy with specially designed electrical surgical knife which can cut recurrent laryngeal nerve branch selectively with its noble curved section. We report a case of a 43-year-old male patient with spasmodic dysphonia treated by thyroarytenoid myoneurectomy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.2
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• pp.83-87
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• 2013

The term "phonosurgery," coined in the early 1960s, refers to surgical procedures that maintain, restore, or enhance the human voice. Phonosurgery includes phonomicrosurgery (endoscopic microsurgery of the vocal folds), laryngoplastic phonosurgery (open-neck surgery that restructures the cartilaginous framework of the larynx and the soft tissues), laryngeal injection (injection of medications as well as synthetic and organic biologic substances), and reinnervation of the larynx. Phonomicrosurgery is a means of maximally preserving the layered microstructure of the vocal fold, that is, the epithelium and lamina propria. The purpose of the surgery is usually to improve the vibratory characteristics of the layered microstructure of the vocal folds. Phonomicrosurgery has developed from convergence of microlaryngoscopic surgical technique theory and the mucosal wave theory of laryngeal sound production. Improvements in technology (i.e., laryngoscopes, handled instruments, and lasers), which in part arise from developments in more frequently performed minimally invasive surgical procedures, will probably facilitate the next generation of procedural innovations. The best methods of optimizing phonosurgical outcomes include making an accurate diagnosis, completing a comprehensive voice evaluation, providing sufficient preoperative therapy, carefully selecting patients to undergo phonomicrosurgical procedures, and requiring sufficient postoperative rest and therapy. Phonomicrosurgery will continue to evolve as a result of the interdependent collaboration of surgeons with voice scientists, speech pathologist, and other voice professionals.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.1
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• pp.54-57
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• 2015

Hemangioma is one of the most common benign neoplasm, which occurs about 50% in head and neck region, but laryngeal hemangioma is relatively rare. Hemangioma occurred in larynx can be treated by surgical removal, cryosurgery, and steroid injection. Transoral CO2 laser micorsurgery has been known as useful method for the treatment of laryngeal hemangioma. We have experienced a 54-years old male patient of hemangioma originated in arytenoid area. This mass was removed via transoral approach with 'en bloc' resection by CO2 laser. We report this case regarding the treatment and prognosis of laryngeal hemangioma with review of literatures.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.2
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• pp.111-114
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• 2006

Objective : The anterior approach to the cervical spine now selves as the surgical across of choice for cervical spine disease. Vocal cord paryalysis(VCP) follow the procedure as a complication, and it is most common complication of this procedure. However, the frequency and etiology of this injury are not clearly defined. This study was performed to establish the clinical features of vocal cord paralysis in anterior cervical spine surgery(ACSS). Material and Method : Retrospectively, medical records of patients who underwent ACSS at Hallym university medical center, Hangang Sacred Heart Hospital between January 2000 and March 2006 were reviewed. Further detailed review of the patients with documented VCP after surgery was then performed. Results : 242 ACSSs were performed and 9 patients with VCP were identified (3.71%) In 9 patients with VCP, 8 patients had right-sided approaches (6.01%) and 1 patient had left-sided approach (0.91%). All 9 patients had VCP on ipsilateral side and 8 patients were recovered completely on follow up period. Duration of ACSS, multilevel exposure and low-level (below the C6 level) exposure have been found to be associated with higher risk. Conclusion : For avoiding the recurrent laryngeal nerve injury, surgeon have to understand the clinical features of VCP in ACSS. As right-sided approach has a greater risk of recurrent laryngeal nerve injury, we suggest that the left-sided approach be given more consideration.

• Archives of Craniofacial Surgery
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• v.20 no.6
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• pp.416-420
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• 2019

Reconstruction method choice in recurrent head and neck cancer depends on surgical history, radiation therapy dosage, conditions of recipient vessels, and general patient condition. Furthermore, when defects are multiple or three dimensional in nature, reconstruction and flap choice aimed at rebuilding the functional structure of the head and neck are difficult. We experienced successful reconstruction of recurrent laryngeal cancer requiring reconstruction of esophageal and tracheostomy stroma defects using a chimeric two-skin anterolateral thigh flap with a single pedicle.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.7 no.1
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• pp.5-10
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• 1996

From October 1991 to June 1995, 4 medialization thyroplasties and I arytenoid adduction were simultaneously performed with the thyroid surgery when the unilateral recurrent laryngeal nerve was paralyzed before or during thyroidectomy. Four cases were papillary carcinoma with direct invasion to the unilateral recurrent laryngeal nerve, and one case was huge adenomatous goiter and the recurrent laryngeal nerve was incidentaly cut. Hoarseness was present preoperatively with mean duration of 15 months and aspiration was also present in three cases. After phonosurgery, voice was improved in 4 out of 5 cases and aspiration subsided in 2 out of 3 cases. In one case, hoarseness continued after total thyroidectomy and thyroplasty type I and the arytenoid adduction with planned due to posterior glottic gap of 2mm. We suggest that the thyroplasty type I or arytenoid adduction are primary phonosurgical procedures which ran be performed concomitantly with neck surgeries in the patients with paralysis of the unilateral recurrent laryngeal or vagus nerve damage during neck surgeries.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.1
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• pp.60-62
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• 2011

Primary laryngeal aspergillosis is rare, It is most often found in immunocompromised patient, such as leukemia, malignant disease, diabetes or immunosuppressive drugs. These days the occurrences of laryngeal aspergillosis in immunocompetent patients are increasing. The cause of laryngeal aspergillosis in immunocompetent patients is not clear, but a few factors are considered such as iatrogenic factors, vocal abuse, vocal fold cyst and occupational factors. The histopathologic characteristics are somewhat different between that of immunocompromised patients and immunocompetent patients. We report a case of primary vocal cord aspergillosis in immunocompetent patient who had treated with only surgery and brief review of the pertinent literature.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.132-136
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• 1998

Nonrecurrence of the inferior laryngeal nerve always results from a vascular anomaly during embryonic development of the aortic arches. The nonrecurrent inferior laryngeal nerve is important clinically for two reasons, it is vulnerable during thyroid surgery and it is associated with difficulty in swallowing. It can be suspected preoperatively from signs associated with the vascular anomaly : dysphagea, thoracic x-ray images showing evidence of retroesophageal subclavian artery, or situs inversus viscerum. If such signs are noted, a barium swallow test and chest computed tomography are justified. We experienced a case of Rt. nonrecurrent inferior laryngeal nerve, which is diagnosed thyroid papillary carcinoma.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.47-50
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• 2018

Trauma, congenital malformation and aging process can be a cause of the deviation of laryngeal prominence in the thyroid cartilage. Among these, the senility is the most common cause. Usually, ossification in the thyroid cartilage has occurred symmetrically, but the asymmetrical event leads to the shift of laryngeal prominence. Also, such deformity can provoke protrusion of false vocal fold. A 75-year-old man with hoarseness and globus sense in throat visited our clinic. Five years ago, he experienced a blunt trauma on left midline neck and had a concave deformity in the left thyroid cartilage lamina. Laryngoscopic findings revealed a marked protrusion in the left false vocal fold. We performed the laryngeal microsurgery to discriminate the tumorous condition. The pathology revealed non-pathologic mucosa. We report a unique and didactic case with a brief literature review.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.1
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• pp.16-20
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• 2015

Post-thyroidectomy dysphonia occurs very frequently. Causes of dysphonia include recurrent laryngeal nerve (RLN) or external branch of superior laryngeal nerve (EBSL) injury, intubation, laryngotracheal fixation and other causes. Patients commonly characterized hoarseness or their voice impairment inability to short or sing and loss of loudness. Although complete recovery can be expected mostly in 3 months without obvious nerve injury, dysphonia lowers patients quality of life. The present review discuss the very kinds of causes of post-thyroidectomy dysphonia.