• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.5 no.1
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• pp.69-74
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• 1994

Thyroplasty type III provides an effective mean of shortening the vocal fold. It is used primarily fer lowering vocal pitch. The indications for this surgery are the male patients with too high a vocal pitch of long duration which has proven resistant to voice therapy and a type of dysphonia characterized by high pitch and a breathy voice, in which the laryngeal findings include a very narrow glottal chink and a small amplitude of vibration, suggesting a stiff vocal cord. In this study, we have experienced two cases of high pitched voice, one is mutational falsetto and other is high pitched, breathy voice with stiff vocal fold. The results were satisfactorily successful with type III thyroplasty. So we report the cases of type III thyroplasty in patients of dysphonia with high pitched voice.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.6 no.1
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• pp.43-45
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• 1995

Type III thyroplasty is a useful surgical procedure reducing the tension of vocal cords by removing the vertical strip of anterior thyroid cartilage and resuturing the cut ends. One of the indications for this procedure is mutational dysphonia, the disease of men who has a childlike vocal pattern even after the process of puberty. We have experienced one case of mutational dysphonia treated with type III thyroplasty. He had high pitched voice from the middle school age and his preoperative fundamental frequency was 272.35 Hz. Two months after the surgery. the fundamental frequency was 129.58 Hz and the patient was also subjectively satisfied with his low-toned voice.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.7 no.1
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• pp.61-68
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• 1996

Failure to change from the higher pitched voice of preadolescence to the lower pitched voice of adolescence and adulthood is called "mutational dysphonia" The voice is weak, thin, breathy, hoarse, and mono-pitched. If the voice theraphy was failed, surgery to lower vocal pitch which is refered to thyroplasty type III, is indicated. We compared the post-op acoustic parameters with pre-op data in unilateral antero-posterior shortening of the thyroid cartilage method and bilateral antero-posterior shortening of the thyroid cartilage method each other. Bilateral antero-posterior shortening of the thyroid cartilage method shows significant drop of fundamental frequency and speaking fundamental frequency statistically than unilateral shortening method. There was no significant differences in Jitter, Shimmer, SNR, MFR and other psychoacoustic analysiss parameters between two groups. These data shows that unequal tension of the vocal cord in uilateral antero-posterior shortening of the thyroid cartilage method does not control the pitch effectively so bilatreal shortening method in Type III thyroplasty is recommandable procedure in surgery of the mutational dysphonia.

• Proceedings of the KSLP Conference
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• 1993.12a
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• pp.22-22
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• 1993

병적인 고음성은 임상적으로 흔하지는 않지만 종종 볼 수 있는 질환으로서 치료에 대한 많은 논란이 있는 게 사실이다. 대개 음성교육에 의한 치료가 많이 시행되며 수술적인 치료로서는 제 3형 갑상연골성형술이 인정되어 온 것이 사실이다. 이러한 수술에 대한 적응증으로는 첫째 남자에서 오랫동안 너무 높은 음성(mutational voice disorder)을 가진 환자와 둘째 여러 가지 원인에 의해 성대가 너무 경직되어 고음이면서 애성(breathy voice)을 동반한 발성장애가 있겠다. (중략)

• Proceedings of the KSLP Conference
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• 1994.06b
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• pp.90-90
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• 1994

변성발성장애(Mutational dysphonia)는 원인이 확실히 밝혀져 있지는 않지만, 변성기에 성호르몬의 작용에 의한 정상적인 후두의 발육이 제대로 이루어지지 않아서 발생되는 것으로 추정되고 있다. 임상 양상은 대개 성인 남자임에도 불구하고 병적으로 음성의 기본주파수(fundamental frequency)가 높아서 여자 목소리에 가깝게 들린다는 것을 주 증상으로 하고 있으며, 이학적 검사상 성대의 움직임은 정상이나, 성대의 두께가 얇거나, 성대의 길이가 짧고 긴장도가 증가되어 있는 것 같이 보인다. 음성치료를 시도해 볼 수 있으며, Isshiki가 제 3형 갑상연골성형술로 효과적으로 치료될 수 있다고 보고한 이래, 다수의 보고자들에 의해 시도되어 왔다. (중략)

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.2
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• pp.134-141
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• 1998

Mutational falsetto is a kind of voice disorders due to the failure to acquire proper low-pitched voice during the puberty. The patients with mutational falsetto can produce the normal low-pitched voice by the surgical treatment, like the type III-thyroplasty, or the voice therapy. The present study is, focusing on the latter treatment, to consider the efficiency of voice therapy for the mutational falsetto. The 7 patients who were diagnosed as mutational falsetto by the laryngologists, and treated by the voice therapist were selected as subjects. Their voices of pretherapy and posttherapy were analyzed on the aspects of acoustics and aerodynamics. Acoustic analysis was done by the MDVP(Multidimensional Voice Program) of CSL(Computerized Speech Lab, Kay Elemetrics, Co.), and aerodynamic analysis, by the Maximum Sustained Phonation of Aerophone II(Kay Elemetrics, Co.). By these measurements, we could find that fundamental frequency(F0) was significantly lowered, on the average, 65Hz. Maximum phonation time(MPT) was increased 4.57 second, and shimmer was decreased 1.644%, respectively, and each changes was statistically significant, too. On the average, jitter was decreased 0.499%, mean flow rate(MFR) was decreased 27.71ml/sec, and NHR was increased 0.023 which was the only parameter not showing improvement. But the changes of jitter, MFR and NHR were not statistically significant.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.11-15
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• 2008

Endoscopic laser cordectomy is known as an oncologically sound procedure for T1 and selected T2 glottic carcinoma ; it has comparable local control rate and better long-term laryngeal preservation rate when compared with those of radiotherapy. Even if results of the reported voice outcome studies after surgery or radiotherapy are diverse and controversial, resection deeper than the body layer of the vocal fold (type III, IV, V cordectomy) usually leads to aerodynamic insufficiency during phonation and results in poor voice quality. A keyhole defect or development of synechiae at the anterior commissure after type VI cordecomy may also result in unsatisfactory vocal outcome. However, many advances in phonosurgical techniques are reported to be successfully applied in the reconstruction of glottal defect that is subsequent to endoscopic laser cordectomy. In case of glottal insufficiency, voice restoration can be achieved by means of augmentation of the paraglottic space or medialization of the excavated vocal fold. Injection laryngoplasty with synthetic materials or autologous fat is gaining its popularity for restoring minor glottal volume defect because of its convenience. Laryngeal framework surgery, especially type I thyroplasty with premade implant systems or Gore-Tex, is most frequently used to correct larger glottic volume defect. In case of anterior commissural keyhole defect, additional procedure including laryngofissure may be required. For anterior commissural synechiae, laryngeal keel may be inserted for several weeks or mitomycin-C may be repeatedly applied after the division of adhesive scar to prevent restenosis. In this paper, current concepts and the authors' experiences of phonosurgical reconstruction of vocal function after endoscopic cordectomy will be introduced.