• Journal of Korean Neurosurgical Society
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• v.53 no.6
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• pp.364-367
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• 2013

Microvascular decompression is a very effective and relatively safe surgical modality in the treatment of hemifacial spasm. But rare debilitating complications have been reported such as cranial nerve dysfunctions. We have experienced a very rare case of unilateral soft palate palsy without the involvement of vocal cord following microvascular decompression. A 33-year-old female presented to our out-patient clinic with a history of left hemifacial spasm for 5 years. On postoperative 5th day, patient started to exhibit hoarsness with swallowing difficulty. Symptoms persisted despite rehabilitation. Various laboratory work up with magnetic resonance image showed no abnormal lesions. Two years after surgery patient showed complete recovery of unitaleral soft palate palsy. Various etiologies of unilateral soft palate palsy are reviewed as the treatment and prognosis differs greatly on the cause. Although rare, it is important to keep in mind that such complication could occur after microvascular decompression.

• Journal of Korea Multimedia Society
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• v.25 no.5
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• pp.661-669
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• 2022

The purpose of this study is to compare and analyze Deep Learning (DL) and Digital Image Processing (DIP) techniques using the results of the glottis segmentation of the two methods followed by the quantification of the asymmetric degree of the vocal cord mucosa. The data consists of 40 normal and abnormal images. The DL model is based on Deeplab V3 architecture, and the Canny edge detector algorithm and morphological operations are used for the DIP technique. According to the segmentation results, the average accuracy of the DL model and the DIP was 97.5% and 94.7% respectively. The quantification results showed high correlation coefficients for both the DL experiment (r=0.8512, p<0.0001) and the DIP experiment (r=0.7784, p<0.0001). In the conclusion, the DL model showed relatively higher segmentation accuracy than the DIP. In this paper, we propose the clinical applicability of this technique applying the segmentation and asymmetric quantification algorithm to the glottal area in the laryngoscopic images.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.1
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• pp.28-33
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• 2019

Background and Objectives : Laryngeal electromyography (LEMG) is valuable to evaluate the innervation status of the laryngeal muscles and the prognosis of vocal fold paralysis (VFP). However, there is a lack of agreement on quantitative interpretation of LEMG. The aim of this study is to measure the motor unit action potentials (MUAP) quantitatively in order to find cut-off values of amplitude, duration, phase for unilateral vocal fold paralysis patients. Materials and Method : Retrospective chart review was performed for the unilateral VFP patients who underwent LEMG from March 2016 to May 2018. Patient's demography, cause of VFP, vocal cord mobility, and LEMG finding were analyzed. The difference between normal and paralyzed vocal folds and cut-off values of duration, amplitude, and phase in MUAP were evaluated. Results : Thirty-six patients were enrolled in this study. Paralyzed vocal fold had significantly longer duration (p=0.021), lower amplitude (p=0.000), and smaller phase (p=0.012) than the normal. The cut-off values of duration, amplitude, and phase in MUAP for unilateral VFP were 5.15 ms, $68.35{\mu}V$, and 1.85 respectively. Conclusion : An analysis of MUAP successfully provided quantitative differences between normal and paralyzed vocal folds. But, additional research is needed to get more available cut-off value which is helpful to evaluate the status of laryngeal innervations.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.2
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• pp.149-153
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• 1999

Relapsing polychondritis is an uncommon disorder of unknown etiology. That involves multisystem characterized by recurrent inflammation, degenerative change of multiple cartilaginous structures. The most common clinical manifestation is an auricular chondritis. Other involving systems are joint, nose, eye, larynx, trachea, aorta, heart and kidney. A 26-year-old man who complained of hoarseness and sore throat was referred to the ENT department from internal medicine department. On initial video-laryngoscopic and radiologic examination, there was no abnormal finding. Treatment with high doses of corticosteroid and methotrexate was not effective. Symptoms were aggrevated with dyspnea. Three months later, on video-laryngoscopic examination, bilateral cord fixation with swelling was noted. The radiologic finding showed subglottic stenosis due to collapse of anterior wall of cricoid cartilage. The condition was managed with tracheotomy. We report a case of relapsing polychondritis involving larynx and trachea with bilateral vocal cord palsy which was managed with tracheotomy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.101-103
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• 2015

There are no standard consensus about treatment results and prognostic factors based on randomized trials for benign vocal fold lesion. Currently, voice therapy is the treatment of choice for vocal nodules, and laryngomicroscopic surgery is for vocal polyps. There are no strong evidences to support it, based on randomized controlled trials, But, it's just a consensus among laryngologist. Considering the pathophysiology of benign vocal cord lesions, cognitive behavioral therapy that corrects the patient's bad voice habits and improves their vocal hygiene could be most important factor for treatment outcomes.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.1
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• pp.54-57
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• 2008

Non-visualization of larynx is one of the reasons for failure of vocal fold surgery. Many otorhinolaryngologists may have a trouble in choice of alternative treatment if they experience this situation. The laryngeal mask airway could be alternative approach for this situation. We report a glottal papillomatous patient who was treated by pulsed dye laser via laryngeal mask airway after failure of vocal fold surgery via endotracheal intubation. The patient was a 73-year-old man. Laryngoscopy revealed a severe diffuse papillomatous lesion on right true vocal cord, anterior commissure, and partial left true vocal cord. The patient was refered for difficult laryngeal exposure during laryngomicrosurgey under general endotracheal anesthesia.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.71-71
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• 1993

Diplophonia is produced by the voice of two separate tones and produced through quasi-periodic variations in the vocal cord vibration. Diplophonia is generally regarded as a symptom of laryngeal pathology. The difference in the vibratory frequency between the vocal cords can be seen in a tension imbalance and a difference in the level of the vocal folds under the special condition such as incomplete glottal closure. So authors have experienced 19 cases of patient with diplophonia for the unilateral vocal cord paralysis, intracordal cysts and other mass lesions. And we analysed the diplophonic voice with peak variability and noise level for the quasi-periodic waveforms and spectrograms pre-and postoperatively.

• Proceedings of the KSLP Conference
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• 2003.11a
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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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.1
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• pp.34-39
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• 2015

Background and Objectives:The Voice Handicap Index (VHI) evaluates the patients perception of impact of voice disorder in term of functional, physical, emotional factors. The purpose of this study was to evaluate the change of patient's subjective voice handicap index before and after laryngeal microsurgery for benign vocal cord lesions. Materials and Methods:We analyzed 55 patients who received laryngeal microsurgery for benign vocal cord disease from January 2011 to February 2013 retrospectively. There were 50 vocal nodules, 3 vocal polyps, 2 vocal cysts. VHI were analyzed before surgery and 3 months after surgery. Results:The VHI scores showed statistically significant reductions postoperatively in functional and emotional VHI (p=0.01 and p=0.034). Also, Emotional VHI score after microsurgery was higher in female than male [adjusted odd ratio (AOR)=0.292 ; 95% confidence interval, CI=0.098-0.869, p=0.01]. Conclusion:In other words, males experience significant more emotional effects that are improved after microscopic surgery.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.19 no.2
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• pp.142-145
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• 2008

Background and Object: The aim of this study is to evaluate the change of patient's subjective voice handicap index (VHI) and acoustic parameters before and after laryngeal microsurgery for benign vocal cord disease. Materials and Method: We analyzed 78 patients who received laryngeal microsurgery for benign vocal cord disease from January 2004 to February 2007 retrospectively. There were 28 vocal polyp, 40 vocal nodule, 5 intracordal cyst and 5 Reinke's edema. Jitter, shimmer, harmony to noise ratio (HNR) were analyzed before surgery and 2-3months after surgery using the Doctor's speech science program. The voice handicap index introduced by the Pittsburgh Voice Center was used to examine patient's subjective change of voice quality. Results: Acoustic parameters of jitter, shimmer and HNR were improved in patients with vocal polyp and vocal nodule after surgery. The acoustic parameters were not improved in patients with Reinke's edema, statistically. Only jitter was improved significantly in patients with intracordal cyst (p<0.05). The VHI was significantly improved after surgery. The change of jitter and shimmer was significantly correlated with the change of VHI after surgery. Conclusion: The acoustic parameters and VHI were significantly improved in patients with benign vocal disease after laryngeal microsurgery.