• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.2
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• pp.71-78
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• 2017

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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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.

• Journal of Biomedical Engineering Research
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• v.43 no.2
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• pp.102-108
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• 2022

Purpose: To propose a deep learning-based clinical decision support technique for laryngeal disease on epiglottis, tongue and vocal cords. Materials and Methods: A total of 873 laryngeal endoscopic images were acquired from the PACS database of Pusan N ational University Yangsan Hospital. and VGG16 model was applied with transfer learning and fine-tuning. Results: The values of precision, recall, accuracy and F1-score for test dataset were 0.94, 0.97, 0.95 and 0.95 for epiglottis images, 0.91, 1.00, 0.95 and 0.95 for tongue images, and 0.90, 0.64, 0.73 and 0.75 for vocal cord images, respectively. Conclusion: Experimental results demonstrated that the proposed model have a potential as a tool for decision-supporting of otolaryngologist during manual inspection of laryngeal endoscopic images.

• Proceedings of the KSLP Conference
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• 2003.11a
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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.

• Proceedings of the IEEK Conference
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• 2000.11d
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• pp.203-206
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• 2000

Since the amplitude of voiced fall off at about -20dB/decade, dynamic range is often compressed prior to spectral analysis so that details at weak, high frequencies may be visible. Preemphasizing the speech, either by differentiating the analog speech s$\sub$a(t) prior to A/D conversion or by differencing the discrete-time s(n)=s$\sub$a(nT), compensating for falloff at high frequencies. The most common form of preemphasis is y(n)=s(n)-As(n-1), where A typically lies between 0.9 and 1.0 and reflects the degree of pre-emphasis. In This paper, we proposed that A is adjusted at each time by measuring the slope of envelope in frequency domain.

• Speech Sciences
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• v.7 no.3
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• pp.153-165
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• 2000

During the phonation of voiced sounds, instants exist where the glottis is opened or closed, due to the periodic vibration of the vocal cord. When closed, this is called the glottal closure instant(GCI) or epoch.. The correct detection of the GCI is one of the important problems in speech processing for pitch detection, pitch synchronous analysis, and so on. Recently, it has been shown that the local maxima points of the wavelet transformed speech signal correspond to the GCIs of speech signal. In this paper, we investigate the accuracy of Gels estimated from this wavelet transformed speech signal. For this purpose we compare them with the negative peak points of the differentiated EGG signal that represents the actual GCIs of speech signal.

• Proceedings of the KAIS Fall Conference
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• 2010.05a
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• pp.253-256
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• 2010

Since the amplitude of voiced fall off at about -20dB/decade, dynamic range is often compressed prior to spectral analysis so that details at weak, high frequencies may be visible. Preemphasizing the speech, either by differentiating the analog speech $s_a$(t) prior to A/D conversion or by differencing the discrete-time s(n)=$s_a$(nT), compensating for falloff at high frequencies. The most common form of preemphasis is y(n)=s(n)-As(n-1), where A typically lies between 0.9 and 1.0 and reflects the degree of pre-emphasis. In this paper, we proposed that A is adjusted at each time by measuring the slope of envelope in frequency domain.

• Radiation Oncology Journal
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• v.8 no.2
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• pp.199-205
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• 1990

During a ten-year period from 1978 through 1987, 44 patients with T2NOMO glottic cancer were treated with radical radiation therapy at the Yonsei University Medical Center. Forty-two patients had a minimum follow-up of 3 years, and $81\%$ had at least five years of follow-up. Patients were staged according to the AJCC system. Forty-two patients have been analyzed in detail with respect to two variables: the status of vocal cord mobility and the degree of local extension of the disease. Five-year local recurrence free survival rates were as follows: All 42 patients, $53.3\%$ patients with normal vocal cord mobility (n =18), $69.1\%$ versus patients with impaired vocal cord mobility (n=24), $43.4\%$(p<0.05); patients with subglottic extension (n=15), $36.7$ versus patients without subglottic extension (n=29), $61.9\%$ (p<0.05). The most favorable Prognostic group included the patients with normal mobility without subglottic extension (n=14), $83.1\%$. On the basis of this analysis, we confirmed the presence of heterogeneity in T2NOMO glottic cancer This study indicates that further randomized controlled trials are warranted to evaluate.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1979.05a
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• pp.7.2-8
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• 1979

The tests related to air usage are valuable for evaluating phonatory function of clinical cases having glottic incompetence. Measurement of mean air flow rate, maximum phonation time and phonation quotient are important test for voice disorder. Stroboscopy is very useful for clinical evaluation of abnormality in the mode of vocal cord vibration. Author obtained following clinical result from 56 cases of laryngeal disorders in Kurume medical school in Japan. 1) Unilateral laryngeal lesions, are 35 cases (62.5%) and bilateral laryngeal lesions are 21 cases (37.5%). 2) Sex ratio is 39 cases (69.8%) of male and 17 cases (30.2%) of female. 3) In maximum phonation time below 10 seconds are 26 cases (46.4%) and above 10 seconds are 30 cases (53.6%). 4) In phonation quotient below 300 ml/sec are 33cases (58.9%). and above 300ml/sec are 23 cases (41.0%). 5) In mean air flow rate below 300ml/sec are 37 cases (66.1%) and above 300ml/sec are 19 cases (33.9%). 6) Symmetry of vibratory movement of the vocal cord, regularity of vibration, amplitude of vibration, wave on the mucosa and glottic closures are observed by stroboscopic examination. 7) Postoperative voice test and stroboscopic examination revealed good result in compare pre-operation with post-operation.

• 대한핵의학회:학술대회논문집
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• 2005.11a
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• pp.345.2-345.2
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• 2005