• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.35-38
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• 2020

Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients' symptom fluctuating, called 'Botox rollercoaster.' Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

• 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.17 no.2
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• pp.146-148
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• 2006

Spasmodic dysphonia is a voice disorder characterized by involuntary voice breaks during speech. Adductor spasmodic dysphonia is most common and characterized by strained and strangled voice breaks. The current standard of treatment of therapy for adductor spasmodic dysphonia is chemodenervation of thyroarytenoid muscle with botulinum toxin(Botox). However, Botox is a temporary treatment with each injection lasting approximately 3 months on average and require repeated injections. In this study, we report our experience with surgical treatment for adductor spasmodic dysphonia. In this procedure, the thyroarytenoid branch and lateral cricoarytenoid branch of recurrent laryngeal nerve is selectively denervated unilaterally, and its distal nerve stump of thyroarytenoid branch is reinnervated with branch of the usa cervicalis nerve. And lateral cricoarytenoid muscle partial myotomy was done unilaterally. After 6 months of treatment, voice fluency had improved and no period of breathiness or dysphagia was noted.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.188-192
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• 2002

Unilateral vocal cord palsy which is associated with laryngeal trauma is not uncommon event. In a 42-year-old male, a cricoid cartilage fracure had been developed after blunt trauma. The endoscopic findings showed contusion and diffuse swelling around the left arytenoid and false cord. During phonation, the mobility of left side true vocal cord was decreased. There were no level difference and displacement of the left side arytenoid. We used the laryngeal electromyography (LEMG) to make a differential diagnosis between the cricoarytenoid joint dislocation and the injury of recurrent laryngeal nerve. At the right thyroarytenoid muscle and cricothyroid muscle, the findings of LEMG were normal. But the amplitude and frequency during phonation were decreased (partial denervation) at the left thyroarytenoid muscle. LEMG is a very useful method to predict the diagnosis of vocal cord palsy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.2
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• pp.89-97
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• 2006

The stop consonants in Korean are classified into three types according to the manner of articulation as unaspirated (UA), slightly aspirated (SA) and heavily aspirated (HA) stops. Both the UA and the HA types are always voiceless in any environment. Generally, the voice onset time (VOT) could be measured spectrographically from release of consonant burst to onset of following vowel. The VOT of the UA type is within 20 msec of the burst, and about 40-50 msec in the SA and 50-70 msec in the HA. There have been many efforts to clarify properties that differentiate these manner categories. Umeda, et $al^{1)}$ studied that the fundamental frequency at voice onset after both the UA and HA consonants was higher than that for the SA consonants, and the voice onset times were longest in the HA followed by the SA and UA. Han, et $al^{2)}$ reported in their speech synthesis and perception studies that the SA and UA stops differed primarily in terms of a gradual versus a relatively rapid intensity build-up of the following vowel after the stop release. Lee, et $al^{3)}$ measured both the intraoral and subglottal air pressure that the subglottal pressure was higher for the HA stop than for the other two stops. They also compared the dynamic pattern of the subglottal pressure slope for the three categories and found that the HA stop showed the most rapid increase in subglottal pressure in the time period immediately before the stop release. $Kagaya^{4)}$ reported fiberscopic and acoustic studies of the Korean stops. He mentioned that the UA type may be characterized by a completely adducted state of the vocal folds, stiffened vocal folds and the abrupt decreasing of the stiffness near the voice onset, while the HA type may be characterized by an extensively abducted state of the vocal folds and a heightened subglottal pressure. On the other hand, none of these positive gestures are observed for the SA type. Hong, et $al^{5)}$ studied electromyographic activity of the thyroarytenoid and posterior cricoarytenoid (PCA) muscles during stop production. He reported a marked and early activation of the PCA muscle associated with a steep reactivation of the thyroarytenoid muscle before voice onset in the production of the HA consonants. For the production of the UA consonants, little or no activation of the PCA muscle and earliest and most marked reactivation of the thyroarytenoid muscle were characteristic. For the SA consonants, he reported a more moderate activation of the PCA muscle than for the UA consonant, and the least and the latest reactivation of the thyroarytenoid muscle. Hong, et $al^{6)}$ studied the observation of the vibratory movements of vocal fold edges in terms of laryngeal gestures according to the different types of stop consonants. The movements of vocal fold edges were evaluated using high speed digital images. EGG signals and acoustic waveforms were also evaluated and related to the vibratory movements of vocal fold edges during stop production.

• Proceedings of the KSLP Conference
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• 1994.06a
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• pp.138-142
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• 1994

Types of muscle fiber (Table omitted) Thyroarytenoid ; higher proportion of TypeII fiber. Post.cricoarytenoid. Higher proportion of Type fiber ; 52-67%. Type II fiber ; IIA dominant. Rapid contraction ＆fatigue ressitant ; appropriate for endurant action of respiration. Muscle fiber type grouping(Teig E et al, 1978). (omitted)

• Proceedings of the KSLP Conference
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• 1998.11a
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• pp.210-210
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• 1998

Vocal fold vibration is essentially the propagation of a mucosal wave, starting from the lower surface of the vocal fold. The mucosal upheaval (MU), where the mucosal wave starts and propagates upward, appears only when the vocal fold vibrates. We investigated the location of the mucosal upheaval in response In variations in vocal fold tension. Vibrations were elicited under three conditions: during bilateral thyroarytenoid (TA) muscle contraction, without TA muscle contraction and during vocal fold lengthening. TA muscle contraction was obtained by direct electrical stimulation of the muscle. The vocal fold was lengthened by cricothyroid (omitted)

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.2
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• pp.185-192
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• 1997

Behavior of the intrinsic laryngeal muscles : Thyroarytenoid(TA), cricothyroid(CT), lateral cricoarytenoid(LCA), interarytenoid(IA) and posterior cricoarytenoid(PCA) : were evaluated under the in vivo canine laryngeal model in three individual papers. This is the review of the relating three articles. In vivo preparation of the laryngeal model was summarized. Video-laryngoscopic findings of the individual intrinsic laryngeal muscles were documented by electrical stimulation of the individual muscular branches of the laryngeal nerve. Effects on fundamental frequency, subglottic pressure, intensity and open quotient by the stimulation of the individual intrinsic laryngeal muscles were tested.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.2
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• pp.193-198
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• 1997

Stuttering is a movement disorder of speech-motor control characterized by inappropriate timing of lingual, labial, laryngeal, and respiratory muscles. Treatment for adult stutterers have included traditional and non-traditional behavioral and psychiatric modalities, many with good initial success but all with limited long-term benefit. Recent trials of botulinum toxin injection was somewhat favorable. In this study, the authors injected 5-8 U of botulinum toxin into the thyroarytenoid muscle bilaterally in cases of disabling stutterers. Evaluation after 4 weeks of injection, 80% of the patients was improved more than one positive scale. However, no one was improved to almostly normal range.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.1
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• pp.23-27
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• 2006

Purpose: There are a few case reports on asymmetric vocal cord uptake on FDG-PET in patients with unilateral vocal cord paralysis, which could be a potential pitfall in the interpretation of FDG-PET images. We evaluated the metabolic activity of laryngeal muscles of patients with unilateral vocal cord paralysis in comparison to normal controls during both speech and silence. Methods: Eleven patients with unilateral vocal cord palsy (thyroldectomy=7, lung cancer=1, others=3) and 12 normal controls underwent FDG-PET with usual protocol. They were divided into two groups respectively; one group read books aloud for 20 minutes (phonation group) and the other kept silence (non-phonation groups) after FDG injection. Recent neck CT scan were co-registered with FDG-PET to produce PET-CT fusion images to elaborate small laryngeal muscles. Results: In patients with unilateral vocal cord palsy, contralateral non-paralyzed vocal cord showed hypermetabolism mainly on thyroarytenoid muscle, more intensely with phonation group ($SUV=5.88{\pm}2.65$) than with non-phonation group ($SUV=2.30{\pm}0.39$). Normal control subjects showed hypermetabolism ($3.68{\pm}0.96$) in interarytenoid muscle and symmetric mild hypermetabolism in both lateral cricoarytenoid muscles in only phonation group. Conclusion: FDG-PET with fusion images using CT scan in patients with unilateral vocal cord paralysis showed hypermetabolism of contralateral non-paralyzed thyroarytenoid muscle, suggesting compensatory action during phonation. Phonation durung FDG PET study enhanced FDG uptake on different laryngeal muscles between patients with unilateral vocal cord paralysis and normal subjects.