• 대한후두음성언어의학회지
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• 제30권2호
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• pp.107-111
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• 2019

Background and Objectives Idiopathic unilateral vocal fold paralysis (IVFP) is believed to be due to inflammation and edema of the recurrent laryngeal nerve caused by viral diseases such as upper respiratory tract infections. Corticosteroid has a potent anti-inflammatory action which should minimize nerve damage. The purpose of this study was to investigate the effect of oral steroid therapy on IVFP. Materials and Method Study was performed for the IVFP patient from January 2012 to August 2017. Patient's dermography, direction and location of paralyzed vocal cords, history of hypertension, diabetes, cerebrovascular disease, and other underlying disease, smoking history, alcohol consumption and upper respiratory tract infection, and symptoms were investigated. Treatment was divided into three groups: the observation group, low-dose group, and high-dose group, and the recovery rate and time of vocal cord paralysis were analyzed in each group. Results Thirty-seven patients were enrolled in this study. There was no relationship between oral steroid use, dosage and recovery of vocal cord paralysis. Oral steroids showed a rapid recovery of vocal cord paralysis, but there was no statistically significant difference in the time of recovery of vocal palsy with or without steroids (p=0.673). In addition, there was no statistically significant difference in recovery rate between the period to start of treatment, presence of diabetes mellitus, and treatment modality, but the recovery rate was high in the group with upper respiratory tract infection history (p=0.041). Conclusion In IVFP, oral steroid therapy has no significant difference in time and extent of recovery compared to the case of spontaneous recovery.

• 대한후두음성언어의학회지
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• 제33권1호
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• pp.1-6
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• 2022

Vocal fold injection (VFI) is widely accepted as a first line treatment in treating unilateral vocal fold paralysis and other vocal fold diseases. Although VFI is advantageous for its minimal invasiveness and efficiency, the invisibility of the needle tip remains an essential handicap in precise localization. Real-time light-guided vocal fold injection (RL-VFI) is a novel technique that was developed under the concept of performing simultaneous injection with precise placement of the needle tip under light guidance. RL-VFI has confirmed its possibility of technical implementation and the feasibility in injecting the needle from various directions through ex vivo animal studies. Further in vivo animal study has approved the safety and feasibility of the procedure when various transcutaneous approaches were applied. Currently, RL-VFI device is authorized for clinical use by the Ministry of Food and Drug Safety in South Korea and is clinically applied to patients with safe and favorable outcome. Several clinical studies are currently under process to approve the safety and the efficiency of RL-VFI. RL-VFI is expected to improve the complication rate and the functional outcome of voice. Furthermore, it will support laryngologists in overcoming the steep learning curve by its intuitive guidance.

• 대한후두음성언어의학회지
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• 제31권1호
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• pp.1-6
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• 2020

In unilateral vocal fold paralysis (UVFP) patients, we try to improve their symptoms such as hoarseness or aspiration by restoring nerve functions or medialization laryngoplasty (ML), etc. Until now, ML (thyroplasty and/or arytenoid adduction) is considered as gold standard of treatment for UVFP. However, if recurrent laryngeal nerve (RLN) is damaged and use of RLN is feasible during operation, laryngeal reinnervation (LR) would be a good option. Anastomosis with ansa cervicalis to RLN is most common reinnervation method. Delayed LR may be considered in young patients when the RLN denervation period is not long (less than 2 years) for the treatment of surgery-related UVFP. Injection laryngoplasty and laryngeal framework surgery showed great voice outcomes in UVFP. Combination therapy (neuromuscular pedicle innervation with ML) also showed good post-operative voice outcomes even in longer periods (over 2 years). In pediatric patients, LR would be considered as a good treatment option because all procedures need to general anesthesia.

• 대한후두음성언어의학회지
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• 제26권1호
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• pp.21-24
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• 2015

Voice therapy after post-thyroidectomy dysphonia is designed to improve glottal closure without supraglottic hyperfunction by development of abdominal support for breathing and intrinsic muscle strengthening exercises. Regarding voice therapy of unilateral vocal fold paresis/paralysis, several techniques such as head positioning, digital manipulation, pushing and pulling method are used for trial or temporary therapy. And the holistic voice therapy such as LSVT, Accent method, VFE are useful for hypofunctional voice disorders. These may be effective interventions as a temporary improvement until normal voice recovers or may provide the essentials for long-term rehabilitation.

• 대한음성언어의학회:학술대회논문집
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• 대한음성언어학회 2014년도 제40차 춘계학술대회
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• pp.25-25
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• 2014

• 대한후두음성언어의학회지
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• 제26권2호
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• pp.112-116
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• 2015

Background and Objectives : Aerodynamic analysis is an examination which provides information regarding various vocalization measures indicating laryngeal efficiency. Voice evaluation using such examination must be capable of distinguishing between normal to abnormal voice. It also observes variables on aerodynamic characteristics by gender in regards to patients of vocal disorders, especially of vocal cord paralysis and vocal polyp, and compares the conditions before and after surgery. This paper therefore, seeks to build a framework for establishing standard levels of aerodynamical characteristic on vocal disorders. Subjects and Methods : The study was intended for a total number of 20 patients with vocal polyp or unilateral vocal cord paralysis. Those with the vocal polyp underwent laryngomycroscopy surgery and the vocal cord paralysis, vocal fold injection using Restylane. Aerodynamic analysis fulfilled the Maximum sustained Phonation (MXPH) and Voicing Efficiency (VOEF) by using PAS Model 6600 (KayPENTAX, USA). Results : In MXPH, increase in PHOT were evident with vocal polyp after surgery. As for patients with vocal cord paralysis, MAXDB, MEADB, DHODB, PHOT all have increased and MEAP, PEF, MEAF decreased after surgery. In VOEF, patients with vocal cord paralysis who underwent surgery showed increase in MAXDB, MEADB, DHODB, FET100, ARES, but decreases in PEF, TARF. Conclusion : Overall, it can be concluded that patients with the vocal polyp and vocal cord paralysis seemed to get closer to the normal values after than before surgery in majority of measures. This confirms that the function of their vocal cord has improved nearly to normality through operations.

• 대한후두음성언어의학회지
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• 제15권2호
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• pp.87-91
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• 2004

Background and Objectives : Temporary vocal fold injection is not only performed to restore the laryngeal function in temporary unilateral vocal fold paralysis or paresis, but also performed as a test injection prior to the permanent injection. Gelfoam has been safely used for the past several decades for the temporary vocal fold augmentation. Recently, we found a new material, called Radieses Lite, may be used as a temporary injection material. Material and Methods : We report preliminary results of 11 patients who had Radiesse Lite injection with a variety of pathologies. Results : Based on the results from the 6 patients who completed follow-up, the duration of effectiveness of Radiesse Lite seems to be from 2 to 3 months depending on the injection amount. Radiesse Lite satisfies several requirements of the ideal temporary vocal fold injection material in terms of injectability, convenience, duration of effectiveness and safety. Conclusion : The authors concluded that Radiesse Lite might be a good option for temporary vocal fold injection especially in the office setting.

• 대한후두음성언어의학회지
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• 제10권1호
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• pp.30-36
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• 1999

Background and Objectives : Laryngeal Evoked Electromyography(EEMG) is a objective, quantitative technique to determine innervation status of larynx. The possible applications of this technique are to confirm the etiology of impaired vocal fold motion and monitor perioperative vagus nerve trauma. The purpose of this study is to develop a novel method for determining the amount of reinnervation of recurrent laryngeal nerve with accurate, inexpensive, and minimally invasive technique in human. Materials and Methods : Laryngeal EEMG was performed for 16 adults with intact vocal folds motion and 2 patients diagnosed as unilateral vocal fold paralysis. for the purpose of searching what is the optimal and noninvasive technique for laryngeal EEMG, we used 2 types of stimulation configurations(transcutaneous vs percutaneous) and 2 types of recording configurations(intramuscular vs. surface). Results and Conclusions : Percutaneous needle stimulation and surface recording of laryngeal EEMG was reliable and comparable to standard needle stimulation and invasive intramuscular needle recording. But the laryngeal EEMG by the surface recording and transcutaneous surface stimulation was not reliable and repeatable. Therefore we recommended that laryngeal EEMG by surface recording and percutaneous needle stimulation would be minimally invasive, reliable technique to know the status of reinnervation in e patients with vocal fold paralysis.

• 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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• 제6권1호
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• pp.39-42
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• 1995

Surgical treatment options of symptomatic unilateral vocal fold paralysis are Teflon injection, type Ⅰ thyroplasty, and arytenoid adduction. Arytenoid adduction is preferable to type Ⅰ thyroplasty for correcting the level different that may be present between two vocal folds and the large glottal chink However there is no known therapeutic modality effective to correct the large posterior glottal chink of the vocal fold with relatively normal mobility. Recently we have experienced a case of severe large posterior glottal chink of the vocal 1314s with relatively normal mobility after thyroid lobectomy, successfully treated with type Ⅰ thyroplasty combined with arytenoid adduction.