• 대한후두음성언어의학회지
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• 제29권1호
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• pp.30-36
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• 2018

Background and Objectives : The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. Materials and Method : 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life. Results : In GRBAS scale, G (p<0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p<0.001, p<0.001 p=0.003, p<0.001, and p<0.001 respectively). Conclusion : From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.

• 대한한의학회지
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• 제35권1호
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• pp.26-40
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• 2014

Objectives: This study investigated the effect of electroacupuncture on swallow function in stroke patients with dysphagia. The purpose was to determine whether electroacupuncture could improve swallow function and quality of life for patients with dysphagia caused by stroke. A pilot double-blind, randomized controlled trial design was used Methods: A total of 17 stroke patients with dysphagia were recruited to this study, 8 assigned to the swallowing electroacupuncture (SE) group and 9 to the control group. Swallowing electroacupuncture was assessed for 5 Hz electrical or sham stimulation for 20 min duration 3 times a week. Outcome measurements were DOSS, 14-item questionnaire from the SWAL-QOL, NIHSS and MBI. Assessment was carried out for baseline, 2 weeks and 4 weeks Results: In the 2 weeks follow up data, the study group showed significant difference in DOSS and SWAL-QOL compared with the baseline. The study group also showed significant difference in DOSS and SWAL-QOL compared with the control group. Similarly in the 4 weeks follow up data, the study group showed improvement tendency in DOSS and SWAL-QOL compared with baseline and also with the control. The NIHSS and MBI scores returned no significant differences. The swallowing electroacupuncture was well tolerated in all cases with no serious adverse effects. Conclusions: The findings from the pilot study indicated that electroacupuncture has significant effects on improvement in swallowing function and quality of life. With both inpatients and outpatients, further larger and longer-term follow-up study is needed to confirm this suggestion.

• The Journal of Advanced Prosthodontics
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• 제7권1호
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• pp.8-14
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• 2015

PURPOSE. To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS. Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS. Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION. Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition.

• The Korean Journal of Pain
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• 제11권1호
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• pp.119-123
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• 1998

It is well known that many patients with trigeminal neuralgia suffer from electric shock-like stabbing pains. The pain can be triggered by nonnoxious stimuli such as touching of the face, chewing, talking or swallowing. This 62 year old woman was urgently admitted to the internal medicine department due to abdominal distention and severe general weakness. She has suffered characteristic violent pain triggered by chewing and swallowing for little over 4 years. This resulted in poor oral feeding for prolonged period which left her severely debilitated. The large amount of ascites that developed 20 days before admission and extreme emaciation forced her to bed rest. She also suffered from Herpes Zoster. After medical treatment to improve liver function and severe pain was persisted, the patient was referred to our department for control of pain. We performed right mandibular block with 1% dibucaine 0.4 ml and the effect was excellent. After the pain had subsided, patient was able to take meals more comfortably and improved liver function returned.

• 대한후두음성언어의학회지
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• 제22권1호
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• pp.52-55
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• 2011

Hyperfunction of the upper esophageal sphincter (UES) can cause severe dysphagia. This condition referred as cricopharyngeal dysphagia may occur after head and neck surgery due to altered muscle spasm and stenosis of the pharyngo-esophageal segment. Among various treatment options available, Botulinum toxin A (Botox) injection offers a nonsurgical treatment which is useful especially for debilitated patients, and there has been a recent increase in the clinical use of Botox by otolaryngologists for managing such conditions. A 55-year-old male with base of tongue (BOT) cancer suffered from severe dysphagia after total glossectomy and neck dissection treatment. Videofluoroscopic swallow study (VFSS) and flexible endoscopic evaluation of swallowing (FEES) showed inability to pass food through the UES due to cricopharyngeal spasm. After injection of 10 U of Bot ox into each cricopharyngeus muscles (total 20 U) via EMG-guided percutaneous injection, swallowing function had improved and oral nutrition was possible, with food passing through the UES visualized on VFSS and FEES.

• 재활복지
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• 제22권1호
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• pp.169-194
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• 2018

본 연구는 세 명의 연하장애환자들을 대상으로 후두관련기능의 개선을 목표로 한 치료적 노래부르기 중심의 음악중재를 시행하고, 각 사례 별로 관찰된 변화를 기술한 개별 사례연구이다. 중재는 개별 세션의 형태로 매 회기 30분, 주 3회씩 총 12회기 동안 진행되었으며, 시행된 프로그램은 호흡근 이완, 구강근육운동, 후두상승 유지를 위한 발성과 치료적 노래부르기 등의 순서로 구성되었다. 대상자들의 연하 및 말하기 기능, 삶의 질 등의 변화를 알아보기 위해 매 회기 후두교호운동속도, 최대발성시간, 음성 질 관련 항목 등을 측정하였고, 중재 전후로 설문을 통해 삶의 질을 평가하였다. 중재 과정에서 대상자의 기능적 특성에 따라 구분되는 변화의 양상이 관찰되었고, 중재 후에는 모든 대상자의 후두교호기능 및 음성 질 지표 측정값에 변화가 있었으며, 연하관련 삶의 질 평가점수도 증가하였다. 본 연구를 통해 치료적 노래부르기 중심의 음악중재프로그램이 다양한 원인에 의한 연하장애환자들의 후두관련기능 및 삶의 질 영역에 공통적으로 혜택을 줄 수 있다는 점과, 중재 시 대상자의 기능적 특성에 따라 고려해야 할 부분에 대해 구체적으로 알 수 있었다.

• 재활치료과학
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• 제11권4호
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• pp.69-83
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• 2022

목적 : 본 연구는 발렌버그 증후군 환자에게 적용한 구강운동촉진기술(OMFT) 프로토콜과 신경근전기자극 치료(NMES)의 임상 적용 효과의 가능성을 확인하고자 하였다. 연구방법 : 발렌버그 증후군 환자 1명을 대상으로 OMFT와 NMES를 4주 동안 주 5일, 1일 2회로 각각 40회씩 적용하였다. 중재 전·후의 변화를 비교하기 위해 포괄적 구강안면기능척도(COFFS), 한국판 Mann 삼킴 능력 평가(K-MASA), 침습-흡인 척도(PAS)를 사용하여 평가하였다. 자료 분석은 중재 전·후의 점수 변화를 비교하였다. 결과 : 본 연구에 참여한 대상자에게 중재 전·후로 구강안면기능과 삼킴능력이 향상되었다. 구강운동 기능 중 혀 운동에 비교적 많은 기능적 호전이 나타났으며, 인두기 삼킴이 가능해지는 정도로 평가되었 고, VFSS를 통한 PAS 평가에서도 5점으로 증상의 개선이 관찰되었다. 결론 : 체계적인 OMFT와 운동강도의 NMES를 적용한 초기 연하재활치료는 구강 운동 기능과 연하장애 개선에 가능성을 확인하였다. 향후 OMFT와 NMES를 적용한 중재의 효과에 대한 보완 연구가 필요할 것이다.

• 치위생과학회지
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• 제23권4호
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• pp.378-388
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• 2023

Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.

• Archives of Plastic Surgery
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• 제35권3호
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• pp.255-260
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• 2008

Purpose: Tongue cancer is the most common malignant tumor of the oral cavity and the ultimate goal in treatment of the cancer is not only complete excision and meticulous closure of the wound, but also, reconstruction of a demensional and functional tongue. Our study focuses on various factors, such as defect size, extent of tumor, age, application of mandibulectomy or radiotherapy, and their influences on postoperative speech and swallowing function. Methods: Our study was based on 59 patients who underwent tongue cancer operation and reconstruction of the tongue. Speech and swallowing were evaluated according to categories documented by Sultan and Teichgraeber. Patients were classified into 3 groups as partial glossectomy, hemiglossectomy and total glossectomy groups for evaluation. The average age of the patients were 51, and the mean follow-up period was 4 years 2 months. Results: The partial glossectomy group showed statistically relevant results for speech articulation and swallowing abilities compared to the total glossectomy group. In cases of defects involving the mouth floor, the group showed decreased results compared to the group without mouth floor involvement. Increased age showed decreased postoperative results with statistical significance, while mandibulectomy and radiotherapy revealed no statistically significant data. Analysis according to TNM staging resulted in decreased functional result with advanced staging without statistical significance. Conclusion: To summarize the factors influencing the functional outcome in tongue reconstruction, younger patients and early stage cancer with minimal surgical extent revealed more satisfying results while mandibulectomy and radiation did not have influence on our analysis. Addition of various influencing factors and studies with longer follow up periods on our patient groups may provide effective data for more satisfying functional outcomes in the future.

• 대한기관식도과학회지
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• 제16권1호
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• pp.27-32
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• 2010

Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.