• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.2
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• pp.107-111
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• 2013

Objectives : We developed two-dimensional (2D) scanning videokyomography to evaluate the mucosal wave of whole vocal cords in real time to overcome the limit of preexisting stroboscopy and line scanning videokymography which could not evaluate it. Methods : We implemented a continuous light source with high brightness, a high-definition CMOS camera, and capture board for saving the data. We created the software program to analyze the image data from the system. The test of the functionality of the 2D scanning videokymography camera was performed in one of the authors (P.H.J 32 years old male). Vocal cord images were obtained during normal phonation and falsetto phonation. Images were obtained also during cough, diplophonia. Results : The system made it possible to measure objective parameters, including fundamental frequency, amplitude, regularity, mucosal wave, and phase difference, medial and lateral peak, opening versus closing duration related to vocal fold vibration. Simultaneously, it enabled analysis of the whole mucosal wave of the entire vocal fold in real time. 2D scanning videokymography was also effective for evaluating the dynamic status of the vocal fold when the subject phonated aperiodic voice. Conclusion : In conclusion, 2D scanning videokymography can support the analysis of the whole mucosal wave of the entire vocal cord with objective vocal parameters, overcoming the limitations of stroboscopy and previous line scanning videokymography techniques.

• Korean Journal of Bronchoesophagology
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• v.17 no.1
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• pp.53-56
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• 2011

Vocal cord paralysis (VCP) is a common complication after thyroidectomy despite the continuity of the recurrent laryngeal nerve (RLN) is preserved. Much efforts have been made into preventing VCP, but few of them focuses on the treatment strategies and prognosis after VCP take place. In this case, patient visited the clinic for papillary thyroid cancer in Rt. thyroid gland without VCP. She underwent total thyroidectomy with central neck dissection. During dissection, Rt main mass was encircling Rt. RLN. To make matters worse, Lt. RLN was severed due to tight attachment with Berry's ligament. After that, intratumoural dissection of Rt. RLN and end to end anastomosis of Lt. RLN were performed with microscopy to preserve the functions of RLNs as much as possible, otherwise permanent bilateral VCPs were inevitable. We report this case, since both vocal cords recovered from VCPs with symmetric, synchronous movements at postoperative follow up.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.37A no.9
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• pp.792-798
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• 2012

Network Quotient, an important figure in modern society, the intelligibility of speech as a conversation partner to maximize pulling up feeling of liking it as much as possible has become an important issue. The humidity of air in the intelligibility of speech have many influences. Therefore, in this paper, we carried out experiment to apply voice signal analysis techniques which to analyze influenced vocal cords in 30%, 50% and 80%, maintaining a constant humidity of the environment. With this in mind, we carried out experiments on intensity and pitch of voice signal on twenty male 20s in maintaining a constant humidity 30%, 50% and 80% of humidity. Finally, we carried out study to draw a significance through statistical analysis measuring characteristic parameter of vocal cord function to change of humidity.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.1
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• pp.5-9
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• 2003

Introduction : Laryngomicrosurgery(LMS) is frequent procedure applying to benign and early malignant larygeal disease such as vocal cord polyp, nodule and early glottic cancer. LMS has been known as safe procedure and short time consuming treatment. So few reports about complications in LMS was done. In this study, complications and problems from LMS were investigated and reported. Method : From 2000, January to 2001, December, 180 patients who were treated with LMS in Asan medical center were studied by retrograde chart review. Results : In these patients, total 9 patients(5%) were suffered from complication. 4 patients (2%) had teeth injury and 4(2%) were suffered from foreign body sensation in tongue and 1(1%) had hypoglossal nerve injury. Main mechanism of complications is thought by pressure injury by laryngoscope blade. No definite correlation between procedure and complication was observed. Conclusion : There are few neural complications with LMS such as lingual and hypoglossal nerve injury. Before operation of LMS, warning and informing of complications by mechanical stress must be done. Gentle procedure and short operation time are necessary to avoid these problems. And patients who have risk factors of oral complications such as dental disease or dental prosthesis must have dental evaluation and treatment before LMS procedure.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.11.2-11
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• 1983

Vocal nodules and polyps are much more frequent in singers, public speakers, teachers and actors. Voice trauma and voice misuse, at times associated with mild inflammatory reaction, appear to be important in their etiology. It is generally agreed that vocal cord nodules and polyps are inflammatory in nature and they arise in the subepithelial layer of loose connective tissue of the vocal cord. Since the junction of anterior and middle thirds of the membranous cord and has the greatest amplitude of vibration. This is the site of predilection for vocal cord nodules. The author performed laryngomicrosurgery for 70 cases of vocal nodules and polyps at Ewha Womans University Hospital during the period of 5 years. The result obtained were as follows ; 1) Surgical excision is not necessarily the best approach because vocal nodules in the early stages will resolve with the simplest voice therapy. 2) In children, surgery is rarely indicated because most nodules in children regress during adolescence. 3) For patients who use their voices professionally, voice therapy is indicated for three months. 4) If after three month of conservative treatment the cord lesion does not improve and the patient it still dissatisfied with his voice, laryngomicrosurgery can then be considered. 5) The small cuffed endotracheal tube in the interarytenoid space helps to keep the cords immobile and in an abducted position. 6) Removal of the nodule shoule be started by gentle retraction posteriorly and as soon as a tear appears anterior to the nodule. 7) On occasion it is preferable to start the dissection with a siccle knife while the nodule is held on the stretch. 8) Voice rest should be maintained for a week following which the free edges of the cords are usually healed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.23-27
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• 2005

Background and Objectives : Voice disorders can cause problems in patients with benign vocal cord lesions emotionally, physically, economically and functionally. Neither subjective nor objective voice examinations can evaluate such factors adequately. The Voice Handicap Index (VHI) subjectively evaluates voice disorders in terms of physical, functional, emotional factors and measures the patient's perception of the impact of voice disorder. The purpose of this study is to evaluate the usefulness of VHI in the patients with benign vocal cord lesions. Materials and Method : The authors evaluated 37 patients who experienced laryngeal microsurgery for benign vocal cord lesions from september 2003 to August 2004. The VHI was used to measure the postoperative changes of the patient's perception and acoustic analysis and aerodynamic tests were also done. Statistical analysis was done using paired t-test and Pearson's correlation. Results : The VHI scores showed statistically significant reductions postoperatively. In acoustic analysis, jitter and shimmer had statistically significant reductions after surgery but noise-to-harmonics ratio did not. A statistically significant change in the average MFR and MPT perioperatively was found. The relationship between VHI and acoustic, aerodynamic analysis attained statistical significance. Conclusion : The VHI is a useful assessment tool to monitor the patient's self-perception of voice change after the surgery of benign vocal cord lesions. The VHI measurement, when combined with acoustic and aerodynamic analyses, will be helpful in comparing functional outcomes after voice surgery.

• Phonetics and Speech Sciences
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• v.5 no.1
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• pp.81-90
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• 2013

During adolescence the mutational period is characterized by the changes in the laryngeal structure, the length of the vocal cords, and a tone of voice. Usually, adolescents at 15 or 16 reach the voice of adults but the mutational period is sometimes delayed. Therefore, studies on the voice of adolescents between 16 ~ 18 right after the mutational period are required. Accordingly, this paper attempted to provide basic data about the normal standard for patients with voice disorders during this period by evaluating the vocal characteristics of males and females between 16 ~ 18 with an objective device bycomparing and analyzing them by sex and age. The study was conducted on a total of 60 subjects composed of each 10 subjects of each age. The vocal analysis was conducted by MPT (Maximum Phonation Time) measurement, sustained vowels and sentence reading. As for /a/ sustained vowels, fundamental frequency, hereinafter referred to as $F_0$, jitter, shimmer, noise-to-harmonic ratio, hereinafter referred to as NHR were measured by using the Multi-dimensional voice program (MDVP) among the Multi-Speech program of Computerized Speech Lab (Kay Elemetrics). The sentence reading, mean $F_0$, maximum $F_0$ and minimum $F_0$ were measured using the Real-Time Pitch (RTP) Model 5121 among the Multi-Speech program of Computerized Speech Lab (Kay Elemetrics). As a result, according to sex, there were statistically significant differences in $F_0$, jitter, shimmer, mean $F_0$, maximum $F_0$, and minimum $F_0$; and according to age, there were statistically significant differences in MPT. In conclusion, the voice of the adolescents between 16 ~ 18 reached the maturity levels of adults but the voice quality which can be considered on the scale of voice disorders showed transition to the voice of an adult during the mutational period.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.52-58
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• 1998

BACKGROUND： Aspiration is defined as the laryngeal penetration of secretions below the level of the true vocal cords. Aspiration can result in life-threatening complications, such as bronchospasm, airway obstruction, pneumonia, pulmonary abscess, sepsis, and death. The patient with high vagal palsy had significant aspiration and dysphagia OBJECTIVE： To formulate a step-by-step management paradign for the patients with high vagal palsy MATERIALS AND METHODS : The medical records of 23 patients who were diagnosed as high vagal palsy from September, 1995 to April, 1998 in Seoul National University Hospital were reviewed retrospectively. Eleven patients were managed conservatively and 12 patients were operated to treat chronic aspiration. RESULTS : The main etiologies of high vagal palsy were mass lesions of the skull base such as neurogenic tumor, pseudotumor, meningioma or nasopharyngeal carcinoma. Aspiration and dysphagia improved in 7 out of 11 patients who were managed conservatively after 2.2 months on the average. The patients who were refractory to the conservative management underwent surgery and showed improvement in 10 out of 12 patients. The employed surgical modalities were vocal cord medialization combined with cricopharyngeal myotomy in 7 patients, laryngotracheal separation in 3 patients and arytenoid adduction only in 2 patients. Two patients still had gastrostomy tube due to the persistent symptoms. Two patients had improved after surgery, but died of underlying disease. CONCLUSION : The patients with high vagal palsy are recommended to be managed conservatively for the first 2 months. If aspiration and dysphagia are persisting after conservative management, vocal cord medialization combined with or without cricopharyngeal myotomy should be considered. If failed, laryngotracheal separation or gastrostomy will be the next option based on the control of the oropharyngeal secretion.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.2
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• pp.83-87
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• 2003

Background and Objectives : Sphincteric function of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal cords. We hypothesize that central facilitation is an essential component of a bilateral adductor reflex and that its disturbance could result in weakened sphincteric closure. Materials and Method : Seven adult 20kg dogs underwent evoked response laryngeal electromyoraphy under 0.5 to 1.0 MAC isoflurane anesthesia. The internal branch of superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes and recording electrodes were positioned in the ipsilateral and contralateral thyroaryteonoid muscles. Results : Consistent threshold responses were obtained ipsilaterally under all anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels approached 1.0 MAC. Additionally, at 0.5 MAC, late responses (R2) were detected in one animal. Conclusion : Alteration of central facilitation by deepening anesthesia abolishes the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may improve the prevention of aspiration in patients emerging from prolonged sedation or under heavy psychotropic control.

• Proceedings of KOSOMES biannual meeting
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• 2003.05a
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• pp.153-158
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• 2003

Design of general steel structure had applied and achieve elastic design concept mainly so far. Because elastic design supposes that whole structure complies with elasticity formula as that achieve via allowable stress of material is concept that calculate stress distribution of construction about action external load and estimate load of when the maximum stress reaches equally with allowable stress that is established beforehand by maximum safety load of the structure. But, absence that compose actuality structure by deal with external load increase small success surrender and structure hardness falls and tell structure in limit state finally on the whole as showing complicated conduct by interference between these breakdown at buckling by compression. Examined closely about conduct of place since initial buckling through carbon vocal cords transformation finite element analysis series (ANSYS) that place mending condition supposes case that is boundary condition in this investigation.