• 대한후두음성언어의학회지
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• 제16권1호
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• pp.53-67
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• 2005

It is known that Korean stop consonants in syllable-initial position are of three types : lax, aspirated and forced (or unaspirated). In syllable-final position, however, these three different types are merged to a single type with the same place of articulation, although the original three-way distinction is preserved in Korean orthographic (Hangul) system. Thus the syllable-final stops are phonetically realized as voiceless "applosives" which are characterized by the absence of oral release. The aim of the present study is to investigate the laryngeal adjustments for these syllable-final stops in various phonological conditions by using fiberscope, and, is to further investigate electromyographically the laryngeal adjustments for Korean stops both in the syllable-initial and final positions in various phonological conditions. The results can be summarized as follows : 1. In the case of syllable-initial stops, the glottal widths in each three types of the Korean stops during the articulatory closure are clearly different. And the pattern of thyroarytenoid(VOC) activity appeared to characterize the three different types of Korean stops. 2. The basic laryngeal feature of the Korean syllable-final applosives is characterized by a small degree of glottal opening which begins at or slightly after the oral closure. 3. In the case, syllable-final stop followed by the copula "ita", the syllable- final stop is pronounced as the stop consonant at the initial position of the following syllable containing the vowel[i], the underlying features of three-way distinction for the stops in the Korean orthographic(Hangul) system being manifested at the laryngeal adjustment. 4. In the case of the final applosives followed by the initial stops and fricatives, the laryngeal feature of the final applosives appears to be assimilated by that of the following consonant irrespective of the difference in the place of articulation, as far as the glottal abduction/adduction is concerned. It is clearly demonstrated in the case of syllable-initial stop that thyoarytenoid(VOC) activity is suppressed for the production of the stop consonants in question, the degree of which is slightest for the forced type and most marked for the aspirated type, while it is moderate for the lax type.

• 대한후두음성언어의학회지
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• 제30권2호
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• pp.82-86
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• 2019

In the field of otolaryngology-head and neck surgery, botulinum toxins are widely used for the treatment of spasmodic dysphonia and vocal tremors. Recently, the applications of botulinum toxin have gradually expanded with time, to include vocal fold granuloma, mutational falsetto, bilateral vocal cord paralysis, and chemical reduction for arytenoid dislocation as an adjunctive modality. According to a nation-wide multicenter study conducted by the Korean Society of Laryngology, Phoniatrics and Logopedics for treatment modality of contact granuloma, among the various treatment modalities, botulinum toxin injection showed the highest response rate and lowest recurrence rate in both primary and refractory cases. Therefore, botulinum toxin could be reserved as a second-line treatment for contact granuloma in which the first treatment was not effective, but also could be used as a first-line treatment depending on the patient's and institution's situation. For recalcitrant nodules, injection of botulinum toxin into the bilateral thyroarytenoid muscle will reduce glottal contact force and result in a forceful chemical voice rest. In special situations, botulinum toxin injection could be one of the alternative treatment options for recalcitrant vocal nodules.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.70-70
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• 1993

발성시 기본주파수의 조절은 윤상갑상근과 갑상피열근의 적절한 수축 작용에 의한다는 사실은 잘 알려져 있다. 윤상갑상근의 기능은 자세히 알려져 있는데 반하여, 갑상피열근의 기능은 현재까지 생체 발성 모형이 개발되지 않아 자세한 내용을 알 수 없었기에, 저자들은 갑상피열근 기능 검사를 위한 생체 발성 모형을 고안하였다. 개의 갑상연골에 창문을 만들어서, 반회신경의 마지막 분지인 갑상피열 분지를 확인, 절단하고 전극으로 자극하도록 하였다. 유발된 음성에 대한 갑상피열근 수축의 효과는 성역의 결정에 중요한 결정 요소로 작용되며, 가성 (falsetto) 영역에서 갑상피열근의 수축은 기본주파수 하강을 초래하고, 지성 (modal) 영역에서는 반대로 기본주파수가 상승되었다. 한편, 갑상피열근의 자극에 따라 성문하압은 증가되고 성문개대율 (OQ) 은 감소되었다.

• 음성과학
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• 제9권1호
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• pp.17-26
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• 2002

Voice onset time (VOT) is defined as the time interval from the oral release of a stop consonant to the onset of glottal pulsing in the following vowel. VOT is a temporal characteristic of stop consonants that reflects the complex timing of glottal articulation relative to supraglottal articulation. There have been many reports on efforts to clarify the acoustical and physiological properties that differentiate the three types of Korean stops, including acoustic, fiberscopic, aerodynamic and electromyographic studies. In the acoustic and fiberscopic studies for stop consonants, the voice onset time and glottal width during the production of stops has been known as the longest and largest in the heavily aspirated type followed by the slightly aspirated type and unaspirated types. The thyroarytenoid and posterior cricoarytenoid muscles were physiologically inter-correlated for differentiating these types of stops. However, a review of the English literature shows that the fine movement of the mucosal edges of the vocal folds during the production of stops has not been well documented. In recent. years, a new method for high-speed recording of laryngeal dynamics by use of a digital recording system allows us to observe with fine time resolution. The movements of the vocal fold edges were documented during the period of stop production using a fiberscopic system of high speed digital images. By observing the glottal width and the visual vibratory movements of the vocal folds before voice onset, the heavily aspirated stop was characterized as being more prominent and dynamic than the slightly aspirated and unaspirated stops.

• 대한후두음성언어의학회지
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• 제11권2호
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• pp.178-184
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• 2000

Laryngeal evoked EMG is the objective and quantitative method to measure the innervation of laryngeal muscle. If there is a mobility disorder of vocal cords, the cause and location of neural lesion co be understood by the laryngeal evoked EMG and if there is a vocal cord paralysis, the degree of recovery and the policy of treatment can be determined by it. Recently, the studies of reinnervation after recurrent laryngeal nerve injury have been actively carried out. Laryngeal evoked EMC is useful to these studies. The aim of study is to know whether noninvasive methods for stimulating the recurrent laryngeal nerve and for recording of compound action potential(CAP) using surface electrode are as useful as the invasive method using needle electrode. We obtained EMG of laryngeal muscle by various stimulating and recording methods : 1) Direct nerve stimulation by placing nerve cuff electrode made out of silastic tube and platinum wire and recording by insertion of hook wire electrode into posterior cricoarytenoid(PCA) and thyroarytenoid(TA) muscles, respectively. 2) Recording of compound action potential by surface electrode after stimulation of recurrent laryngeal nerve by the insertion of 27 gauge of needle electrode. 3) Recording of compound action potential by surface electrode after stimulating the recurrent laryngeal nerve by transcutaneous blunt rod electrode at tracheoesophageal groove. The amplitude, duration and latency of the CAP evoked by recurrent laryngeal nerve stimulation were compared among the three groups. The amplitude of CAP was smallest in the group recorded from posterior cricoarytenoid and hyroarytenoid muscle, and that recorded by surface electrode after stimulation by needle electrode was largest. The difference in amplitude between the group by hook wire recording and the two groups by surface electrode recording was significant statistically. There is no significant difference in duration and latency among three groups. Since the waveform of CAP from all three methods has similar duration, latency, we concluded that noninvasive method is a useful as invasive methods.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 2003년도 제19회 학술대회
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• pp.181-181
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• 2003

Objectives : Vocal fold augmentation using injectable material is an easy and simple operation. This study is to evaluate the histology of minced and injected autologous auricular cartilage and fat graft in the augmentation of unilateral vocal fold paralysis using a canine model for two years. Study Design : A prospective study with the contralateral side of the larynx used as the control Methods : Twelve dogs were operated. At first, a piece of auricular cartilage was harvested from ear and minced into tiny chips with a scalpel and scissors. And also, a piece of fat tissue was harvested from inguinal area and minced into tiny chips with a scalpel and scissors. The minced cartilage and fat-paste (0.2ml) was injected using a pressure syringe into the paralyzed thyroarytenoid muscle under direct laryngoscopy. Two animals were sacrificed at 3 days, three at 3 weeks. two at 3 months. one at 6 months, one at 12 months, three at 24 months. Each dog underwent laryngectomy and serial coronal sections of paraffin blocks from the posterior part of the vocal fold were made. Result : There was no significant complication perioperatively and during follow-up. There was acute inflammatory findings in the graft at 3 days and 3 weeks. Only a very small proportion of the injected cartilage was absorbed due to the degenerative change and the overall volume was preserved even when the cells died out. The injected cartilage remained in the larynx until 24 months. Conclusion : The autologous cartilage implant using auricular cartilage was the ideal vocal cord augmentative material for the treatment of glottic incompetence.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어의학회 2003년도 제19회 학술대회
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• pp.180-180
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• 2003

Objectives : Vocal fold augmentation by injectable material under direct visual control is an easy and simple operation. However, when autologous fat or bovine collagen is used, resorption creates a problem. And autologous fascia is debating about absorption now days. This study is to evaluate the histology of minced and injected autologous auricular cartilage and fat graft in the augmentation of unilateral vocal fold paralysis using a canine model. Methods : Nine dogs were operated. At first, a piece of auricular cartilage was harvested from ear and minced into tiny chips with a scalpel. And also, a piece of fat tissue was harvested from inguinal area and minced into tiny chips with a scalpel. Cutting off a section of the recurrent nerve paralyzed the right vocal fold. The minced cartilage and fat-paste (0.2ml) was injected using a pressure syringe into the paralyzed thyroarytenoid muscle under direct laryngoscopy. Two animals were sacrificed at 3 days, three at 3 weeks, two at 3 months, one at 6 months, one at 12 months. Each dog underwent laryngectomy and serial coronal sections of paraffin blocks from the posterior part of the vocal fold were made. Results : There was no significant complication perioperatively and during follow-up. There was acute inflammatory findings in the graft at 3 days and 3 weeks. The injected cartilage remained in the larynx until 12 months. Conclusion : The autologous auricular cartilage graft is well tolerated and may be very effective material for volumetric augmentation on paralyzed vocal cord.

• 대한후두음성언어의학회지
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• 제14권1호
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• pp.40-46
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• 2003

Background and Objectives : The vocal fold granuloma has been associated with vocal abuse, gastroesophageal reflux, endotracheal intubation and habitual throat clearing etc.. Granuloma is benign growth of hypertrophic granulation tissue. It is usually located on the posterior third of vocal fold, in one or both vocal process of the arytenoid cartilage In spite of the voice therapy, steroid therapy, anti-reflex therapy and surgical procedure. The distinct advantage and uniform success rate of each methods have not been generally shown. Authors report that localized injection of botulinum toxin type A (BOTOX$^{\circledR}$) is the promising method both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy or who are poor surgical candidates. Materials and Method : We carried out a retrospective study of 9 patients with the diagnosis of vocal fold granuloma on the videostroboscopic examination from Jan 2000 to Mar 2003. The botulinum toxin type A was injected into one or both thyroarytenoid muscle or lateral cricoarytenoid muscle under the electromyography. The average dosage ranges from 6U to 8U per injection. Results : Unilateral vocal fold granuloma in 7 patients had been resolved completely within 2-3 months after first injection : 5 patients received th\ulcorner GER medical therapy in addition to the Botulinum toxin injections, 2 patients was resolved completely who had shown recurrence after $CO_2$ laser vaporization. 2 patients who had shown recurrence after $1^st$ injection were also completely resolved within 6 months after further injections. Conclusion : We expect that localized injection of Botulinum toxin type A can provide an alternative treatment for the refractory cases to the traditional forms of therapy and avoid the recurrence in conjunction with proper medical and voice therapy against GER and vocal abuse.

• Annals of Rehabilitation Medicine
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• 제41권6호
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• pp.1019-1027
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• 2017

Objective To analyze the clinical characteristics between neurogenic and non-neurogenic cause of vocal cord immobility (VCI). Methods The researchers retrospectively reviewed clinical data of patients who underwent laryngeal electromyography (LEMG). LEMG was performed in the bilateral cricothyroid and thyroarytenoid muscles. A total of 137 patients were enrolled from 2011 to 2016, and they were assigned to either the neurogenic or non-neurogenic VCI group, according to the LEMG results. The clinical characteristics were compared between the two groups and a subgroup analysis was done in the neurogenic group. Results Among the 137 subjects, 94 patients had nerve injury. There were no differences between the neurogenic and non-neurogenic group in terms of demographic data, underlying disease except cancer, and premorbid events. In general characteristics, cancer was significantly higher in the neurogenic group than non-neurogenic group (p=0.001). In the clinical findings, the impaired high pitched 'e' sound and aspiration symptoms were significantly higher in neurogenic group (p=0.039 for impaired high pitched 'e' sound; p=0.021 for aspiration symptoms), and sore throat was more common in the non-neurogenic group (p=0.014). In the subgroup analysis of neurogenic group, hoarseness was more common in recurrent laryngeal neuropathy group than superior laryngeal neuropathy group (p=0.018). Conclusion In patients with suspected vocal cord palsy, impaired high pitched 'e' sound and aspiration symptoms were more common in group with neurogenic cause of VCI. Hoarseness was more frequent in subjects with recurrent laryngeal neuropathy. Thorough clinical evaluation and LEMG are important to differentiate underlying cause of VCI.

• 대한후두음성언어의학회지
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• 제16권2호
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• pp.113-117
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• 2005

Background and Objective : Vocal fold augmentation by injectable material under direct visual control is an easy and simple operation. However, when autologous fat or bovine collagen is used, the resoiption creates a problem. And autologous fascia is debating about absorption now days. We previously reported on the one year results of injected autologous auricular cartilage for volumetric augmentation in paralyzed canine vocal cord. This study evaluates the long-term histomorphologic results of injected autologous auricular cartilage for the augmentation of the paralyzed canine vocal fold at two year. Material and Methods . A prospective trial of autologous cartilage augmentation of vocal cord in animal model. Three dogs were operated upon. A piece of auricular cartilage was harvested from the ear and minced into tiny chips with a scalpel. Fat was harvested from inguinal area and minced with a scalpel. The minced cartilage and fat-paste (0.2ml) was injected using a pressure syringe into the paralyzed thyroarytenoid muscle using direct laryngoscopy. Three animals were sacrificed at 2 years. Each subject underwent laryngectomy and serial coronal sections of paraffin blocks from the posterior vocal fold were made. Results There was no significant complication perioperatively and during follow-up. The injected cartilage which appeared to have lost viability existed in the vocalis muscles until 24 months. Fibrotic change was exhibited in the surrounding injected cartilage. Conclusion : The autologous auricular cartilage graft is well tolerated and may be very effective material for volumetric augmentation on paralyzed vocal cord.