• Korean Journal of Bronchoesophagology
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• v.9 no.1
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• pp.83-86
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• 2003

Background and Objectives : Paradoxical vocal cord movement is a series of paroxysmal adduction of the anterior two-thirds of the vocal cords during respiration or during phonation. The choking, stridor, and wheezing in this condition occur primarily on inhalation, rather than on exhalation. The two pathognomonic diagnostic criterias that need to be assessed during an acute presentation are laryngoscopy with direct visualization of paradoxical adduction of the vocal cords and pulmonary function testing. Materials and Methods : A retrospective review of 3 patients who were referred to otolaryngologist from pulmonology department, and were confirmed by typical laryngoscopic findings with paradoxical adduction of the vocal cords was conducted. Results The patients were misdiagnosed as exercised-induced asthma, and unresponsive to corticosteroid and bronchodilators. Improvement was achieved only by diagnosis with paradoxial vocal cord movement. Biofeed back therapy, voice therapy, treatment for reflux laryngitis improved symptoms. Conclusion The etiology of paradoxical vocal cord movement is unknown. It may be functional or emotional. The functional factors that were proposed are neurologic deficit and gastroesophageal reflux. Management methods of this condition consist of psychological counselling, voice therapy, and antireflux medication.

• Speech Sciences
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• v.13 no.1
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• pp.109-116
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• 2006

In this paper, our study focuses on obtaining the differences of emotional speech in three different vocal tract sections. The vocal tract area was computed from the area function of the emotional speech. The total vocal tract was divided into 3 sections (vocal fold section, middle section and lip section) to acquire the differences in each vocal tract section of emotional speech. The experiment data include 6 emotional speeches from 3 males and 3 females. The 6 emotions consist of neutral, happiness, anger, sadness, fear and boredom. The measured difference is computed by the ratio through comparing each emotional speech with the normal speech. The experimental results present that there is not a remarkable difference at lip section, but the fear and sadness have a great change at the vocal fold part.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.2 no.1
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• pp.24-30
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• 1986

The vocal nodule is one of the major causes of hoarseness. The patholphysiologic mechanism of the vocal nodule is relatively well-known. Chronic mechanical stimuli, such as vocal abuse, causes vocal nodule by a tissue reaction of the vocal cords. Among the 841 patients, who visited the Vocal Dynamic Laboratory at Severance Hospital complaining of the dysphonia between the period of May 1981- May 1985, 169 patients were selected who were diagnosed as vocal nodule by indirect laryngoscopy and a series of phoniatric examination. (omitted)

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.1
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• pp.37-42
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• 1999

The vocal fold has three major function-phonation, respiration and protection, and is richly innervated. The vocal 1314 its autonomic innervation-adrenergic and cholinergic from superior cervical ganglion and the vagus nerve, respectively. The action of both system account for vasoregulation and glandular activity. In e vocal fold several kin of neuropeptides, including SP, CGRP, VIP, TH, NPY, ENK have been reported at the animal including cat or dog. But information regarding the distribution of autonomic nerve fibers containing neuropeptides in the human vocal fold is lacking. Two neuropeptides are of special interest : 1) vasoactive intestinal polypeptide(VIP)that is known to be contained in the parasympathetic(cholinergic) neuron. 2) tyrosine hydroxylase(TH)is located in the cytoplasm of noradrenergic neuron and is the rate-limiting enzyme in noradrenaline synthesis. To understand specific autonomic function of vocal fold we did immunohistochemical examination of VIP and TH in the human vocal fold.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.522-526
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• 1990

We have experienced 2 cases vocal cord paralysis after open heart surgery. One was a postoperatively developed right unilateral vocal cord paralysis after prosthetic mitral valve replacement with tricuspid valve annuloplasty. The other was a postoperative left unilateral vocal cord paralysis after prosthetic aortic and mitral valve replacement with tricuspid annuloplasty. They were intubated for forty-eight and seventy-two hours but after extubation complained of hoarseness, aphonia, anxiety, and ineffective coughing Indirect laryngoscopy performed at about postoperative one week, revealed partial paralysis and decreased mobility of the vocal cord. After active phonation therapy, symptoms were improved gradually and in the follow up indirect laryngoscopy, the vocal cord paralysis was improved. The symptoms were recovered completely at about postoperative one month in both. The cause of vocal cord paralysis after open heart surgery may be any retraction or stretching injury to the recurrent laryngeal nerve, especially right side, during median sternotomy retraction and open heart operation procedures. As a result, avoid of excessive spread of median sternotomy retractor and excessive manipulation and retraction of the heart during open heart procedures will reduce the occurrence of the vocal cord paralysis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.2
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• pp.145-151
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• 2001

Background and Objectives : A voice therapy can be used the basic method for the voice improvement of patients with the voice disorders. However, according to each voice disorders, various results of treatments have been reported. The purpose of this study was to evaluate the clinical features of the patients who did not improved after the voice therapy and to explore factors that could affect the results of the voice therapy. Material and Method : There are patients (n=49) diagnosed as the vocal nodule and patients (n=13) diagnosed as the vocal polyp. They received the voice therapy more than 6 times from September, 2000 to August, 2001. Clinical features, stroboscopic findings, esophagographic findings and PNS x-ray findings were compared between the improved and the nonimproved groups. Results : Before the voice therapy, PNS x-ray found two of all patients had the paranasal sinusitis. 14 of the vocal nodule patients (28.6%) and 8 of the vocal polyp (61.5%) had GERD in the esophagogram. However, the recovery rate after the voice therapy had no significant difference in both the vocal nodule and vocal polyp with GERD. In patients with the vocal nodule, 47 of 49 (95.9%) improved after the voice therapy. 6 of them were found the clearly decreased lesion in the stroboscopy. But, in patients with the vocal polyp, 7 of 13 (53.8%) improved after the voice therapy and did not have improvement through the stroboscopy. Conclusion : If the treatment of GERD is given with the voice therapy after the evaluation of GERD, it is helpful to increase the effects of the voice therapy. And, if patients were improved partially or unimproved after voice therapy, it was important to evaluate all factors-motivation, compliance and cooperation-related with patients will. Through this, some factors might be minimized except diseases differences.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.42-46
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• 2009

Background and Objectives : Vocal polyps and nodules are representative chronic benign laryngeal disease. Treatment options for vocal polyp and nodule in general include voice therapy or laryngeal microsurgery. The purpose of this study was to analyze voice results before and after laryngeal microsurgery. Materials and Method: Vocal polyp and vocal nodule patients were treated by laryngeal microsurgery from March 2004 to December 2006 at Kosin University Hospital. All were women. Voice analysis studies were done before and after laryngeal microsurgery. Five measurements were performed: MPT, Fo, jitter, shimmer and NHR. Results: There was significant improvement in the vocal polyp patients regarding MPT, jitter, shimmer and NHR. Also there was significant improvement in the vocal nodule patients regarding MPT, jitter and shimmer. Conclusion: MPT, jitter, shimmer and NHR will be effective acoustic parameters in documenting the quantitative changes in the vocal polyp patients. MPT, jitter and shimmer will be effective acoustic parameters in documenting the quantitative changes in the vocal nodule patients before and after laryngeal microsurgery.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.1
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• pp.51-54
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• 2013

False vocal fold hypertrophy caused by diverse pathologic lesion, such as laryngeal amyloidosis, laryngeal lipidosis, laryngocele, saccular cyst and sulcus vocalis. False vocal fold hypertrophy, however, is also caused laryngeal structure deformity, irrespective of pathologic lesions. In this article, we report some cases of false vocal fold hypertrophy caused by inward bowing of thyroid cartilage. At the clinic of the department of otorhinolaryngology in Gangnam Severance Hospital, with 3 male complained of hoarseness as subjects, and comfirmed of false vocal fold hypertrophy using the stroboscopy and larynx CT we checked vocal fold and laryngeal structure. Three patients with apparent hypertrophy of false vocal fold were investigated with computerized tomography (CT). In all patients, marked concavity of thyroid cartilage was revealed in CT scan at the level of the false vocal fold, and this deformity of the thyroid cartilage seemed to cause a protrusion of false vocal fold which taken as hypertrophy in stroboscopy. Careful palpation of the larynx and a CT scan taken at the level of the false vocal fold should be useful in determining whether hypertrophy of the false vocal fold is pathologic. For the next articles, It is necessary to discuss for the cause, diagnosis, treatment and prevention of inward bowing of thyroid cartilage.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.102-107
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• 2016

Background and Objectives : Vocal polyps are caused by inflammation induced by stress or irritation. Many patients with vocal polyps complain voice discomfort. For vocal polyps, surgery such as laryngeal microsurgery has been the mainstay of management. We analyzed the clinical features of vocal polyps, and how the size and location of vocal polyps affect the outcomes of surgery. Methods : We retrospectively reviewed 42 patients from March 2014 to December 2015, who were diagnosed as unilateral single vocal polyp. When we operated on a vocal polyp with laryngeal microscopy, we measured their size and location. The quality of voice was evaluated by GRABS scale, jitter, shimmer, NHR (noise to harmonic ratio), MPT (maximum phonation time), and VHI (voice handicap index) before operation and 4 weeks after operation. Results : When we divided the patients into large-sized vocal polyp group (the longest length >3 mm) and small-sized vocal polyp group (the longest length ${\leq}3mm$), all parameter differences tend to be greater at large sized vocal polyp. However, these differences were not statistically significant (p>0.05). When we divided into two groups depending on the volume of vocal polyp, no distinct tendency was found. When we compared the location (anterior, mid and posterior) of vocal polyp with the improvement of voice quality, more change was found at mid portion vocal polyp, except the difference of VHI. However, these differences were also not statistically significant (p>0.05). Conclusion : All parameter differences tend to be greater at large vocal polyp and polyp of the mid location.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.1
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• pp.40-46
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• 2011

Background and Objectives : Vocal fold bowing is an organic voice disorder that is associated with an abnormal structure of the vocal folds whereas vocal fold polyp is a functional voice disorder caused by an abnormal use of the vocal folds. Both types of vocal folds share a common property in that they make one's voice breathy or strained. The purpose of this study is to compare voice from two types of vocal folds and to offer information of clinical importance. Materials and Method: Vocal fold bowing and vocal fold polyp groups consisted of 7 male subjects, respectively. All subjects recorded /a/ in the state of measuring MPT (maximum phonation time), repeating 3 times, by a voice recorder (48 kHz sampling rate; 24 bit quantization). They answered the questions of K-VHI. Time domain parameters (such as perturbation parameters including HNR, Jitter, etc.) were calculated for the whole duration of /a/ and those of the frequency domain were measured in initial 40 ms and stable 40 ms of /a/, respectively. Mann-Whitney V-test was used for the time domain parameters and K-VHI survey, and Wilcoxon signed rank test was applied to the frequency domain parameters (H1, H2, H1-H2). Results: For K-VHI survey and the time domain analysis, there was no significant difference between bowing and polyp group. For frequency domain analysis, H1 and H2 showed a significantly different result between two groups. Vocal fold bowing group has longer duration and lower intensity than that of vocal fold polyp group in the 'aspirated interval', which could be observable prior to ordinary vowel oscillation. Conclusion: Both groups seem to show breathy voice. This could be referred on the basis of the value of H1-H2. The K-VHI survey says that subjects with vocal fold bowing feel more uncomfortable than subjects with vocal fold polyp.