• Title/Summary/Keyword: Vocal Fold

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Development of the Novel Intraoperative Neuromonitoring for Thyroid Surgery (갑상선 수술을 위한 새로운 수술 중 신경감시시스템의 개발)

  • Sung, Eui Suk;Lee, Byung Joo
    • International journal of thyroidology
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    • v.11 no.2
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    • pp.109-116
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    • 2018
  • It is very important to identify recurrent laryngeal nerve (RLN) and prevent RLN injury during thyroid surgery. The intraoperative neuromonitoring (IONM) for the prevention of RLN injury is a useful method because it can identify the location and status of RLN and predict postoperative vocal cord function easily. The IONM consists of a stimulating side that applies electrical stimulation to the nerve and a recording side that measures the surface electromyography (EMG) of the vocal cord muscle through electrode endotracheal tube. The nerve stimulator and surgical dissector are separate instruments. So, during IONM for the prevention of the RLN injury in conventional, endoscopic, or robotic thyroid surgery, repeated exchanging between surgical instruments and the nerve stimulator is inconvenient and time consuming. On the recording side, the accuracy of the electrode endotracheal tube which measures the EMG of the vocalis muscle can be affected by contact with between electrode and vocal fold and position change of patient. We would like to introduce recent several researches to overcome the current limitations of IONM.

Characteristics of respiration and phonation depending on smoking or non smoking by practical musicology students and general male students (실용음악전공학생과 일반남학생의 흡연여부에 따른 호흡과 발성 특성 비교)

  • Kim, Eunhye;Choi, Hong-Shik;Lim, Seong-Eun;Choi, Yaelin
    • Phonetics and Speech Sciences
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    • v.6 no.3
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    • pp.49-56
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    • 2014
  • This research compared the features of respiration and phonation between practical musicology students and general male students, according to their smoking status. Participants of this research are 15 practical musicology male students attending ${\bigcirc}{\bigcirc}$ university and 16 general ${\bigcirc}{\bigcirc}{\bigcirc}$ university students. The participants, both non-smokers and smokers with 5-years of smoking history have no history of voice disease in any case and have normal cognitive functions. The results indicated that, first, there is not a notable difference in the respiratory activity status(FVC, FEV1, FEV1/FVC), regardless of major and smoking status. In MPT, even though there is no significant difference in accordance with their majors, considering smoking status, the smoker group was shorter than non-smoker group significant difference statistically (p<.01). Second, the divisions of participants' major did not show significant difference in Fo, jitter, shimmer, and NHR in the vowel prolongation task. However, the smoker group showed a significantly higher degree of jitter and shimmer than the non-smoker group (p<.05) as Fo and NHR shows no difference. In the case of VRP, maximum frequency and frequency range of the practical group are significantly higher than normal group statistically (p<.001). Moreover, although the difference of the minimum frequency shown at the statistic is not significant, practical group showed a higher tendency of frequency than normal group (p=.051). In conclusion, even though there is no difference in respiratory activity between the smoker group and non-smoker group, the MPT of the smoker group is shorter than that of non-smoker group. In addition, the smoker group showed a higher degree of jitter and shimmer than the non-smoker group. MPT is related to the valve action of vocal fold that passes through the glottis. Thus, it is interpreted that the smoker group has a lower quality of voice and valve action of the vocal fold. Also, the practical group has a higher degree of maximum frequency and frequency range than the normal group. This research can function as basic data for vocal characteristics for the majors in relation to the voice-specializing.

Clinical Characteristics of the Intracordal Cysts (성대낭종의 임상적 특성)

  • 홍기환;이상헌;최승철;임현실;김연우;전희석;양윤수
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.13 no.2
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    • pp.173-179
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    • 2002
  • Background and Objectives : Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They nay occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. Recently, with the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Method : In the present study, 121 cases of the intracordal cyst were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 121 cases in the 2595 patients who underwent laryngeal micorosurgery(4.7%). Ductal cyst were 88 cases and epidermoid cyst were 33 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the indirect laryngoscopic examination, the ductal cysts are more frequently misdiagnosed as other diseases of the vocal cord such as vocal polyps or nodules. The degree of postoperative voice satisfaction is similar to that of vocal polyps. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without upture of the cystic wall or injury of the lamina propria.

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Clinical Characteristics of the Intracordal Cysts (성대낭종의 임상적 특성)

  • Cho, Young-Ju;Yang, Yoon-Su;Yoon, Yong-Joo;Kwon, Sam-Hyun;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.47-51
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    • 2009
  • Background and Objectives: Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They may occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. With the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Methods: In the present study, 212 cases of the intracordal cysts were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 212 cases in the 4,20 I patients who underwent laryngeal microsurgery (5.04%). Ductal cysts were 156 cases and epidermoid cysts were 56 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the preoperative laryngoscopic examination, the intracordal cysts were mostly misdiagnosed as other disease of the vocal cord such as vocal polyps or nodules. And main cause of intracordal cysts was thought of vocal abuse. From view of the surgical approach, Ductal cysts was difficult to remove completely than epidermoid cyst without cystic wall rupture. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without rupture of the cystic wall or injury of the lamina propria. And marsupialization is meaningful to ductal cyst that cannot be enucleated completely.

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The Role of the Cricopharyngeus Muscle in Pitch Control - Electromyographic and radiographic studies

  • Hong, Ki-Hwan;Kim, Hyun-Ki;Yang, Yoon-Soo
    • Speech Sciences
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    • v.11 no.1
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    • pp.73-83
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    • 2004
  • Electromyographic studies of the cricopharyngeus muscle using hooked wire electrodes were performed in thyroidectomized patients. The shape of the cricoid cartilage and soft tissue thickness in the postcricoid area were evaluated during pitch elevation and pitch lowering using conventional neck lateral films. The cricopharyngeus muscle simultaneously activated in the initial task of speech and continuously activated. Its activity lessened in the interrogative stress contrast of sentence terminals and increased in the pitch lowered contrast of sentence terminal. On the radiologic findings the cricoid cartilage was tilted backward during high pitched phonation and tilted forward during low pitched phonation. The soft tissue thickness of postcricoid area was thicker at the low pitch than at high pitch. At low pitch the cricoid cartilage paralleled along the vertebral column. This result suggests that the bulging of cricopharyngeus muscle in contraction induce a thickened the postcricoid area thickened, and exert pressure anteriorly exerted on the cricoid cartilage. This contraction of the cricopharyngeus muscle may result in shortening the vocal fold and lowering pitch.

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Vocal Fold Palsy Induced by Seldinger Technique for Totally Implantable Venous Access Device (셀딩거 방법을 이용한 TIVAD 삽입 시 발생한 성대마비 1예)

  • Park, Hoon;Lee, Myung-Chul;Kim, Young-Bum;Lee, Guk-Haeng
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.2
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    • pp.129-131
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    • 2012
  • 셀딩거 방법을 이용한 TIVAD 삽입 시 신경손상으로 인하여 성대마비가 발생할 가능성은 아주 낮은 것으로 알려져 있다. 본원에서 셀딩거 방법을 이용한 TIVAD 삽입 후 우측 성대마비가 발생한 18세 남아환자에서 초음파 검사를 시행하여 미주신경의 손상을 확인한 증례가 있어 보고하고자 한다.

Botulinum Toxin for other Head and Neck Lesions (기타 두경부 병변에서의 보툴리눔 독소의 이용)

  • Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.23 no.2
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    • pp.104-110
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    • 2012
  • The usages of botulinum toxin were most commonly for the treatment of spasmodic dysphonia in the otolaryngology field. It has been not only widely used in otolaryngology-Head Neck surgery but also plastic surgery, ophthalmology, rehabilitation medicine, and orthopedics. Now botulinum toxin is used such as blepharospasm (excessive blinking), strabismus, cosmetic, muscle spasms, upper motor neuron syndrome, severe primary axillary hyperhidrosis (excessive sweating), cervical dystonia (spasmodic torticollis), chronic migraine, bruxism, and achalasia. The indication of this drug still gradually expanding with the times. In this articles, the author will demontrate how to use the botulinum toxin for treating cricopharyngeal spasm, arytenoid dislocation, sialocele, Frey syndrome, contact granuloma, bilateral vocal fold paralysis, and mutaional falsetto instead of conventional surgical treatment.

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Irritable Larynx Syndrome with Dyspnea (호흡곤란을 동반하는 과민성 후두 증후군)

  • Ahn, Cheol Min
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.1
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    • pp.21-24
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    • 2016
  • An irritable larynx syndrome is characterized by a sudden episodic dyspnea and dysphonia that is difficult to diagnose, and patients are often treated unnecessarily and/or too much. A correct diagnosis can be made by monitoring the larynx closing in the reversed direction during inhalation and posterior chink with videolaryngoscopy and by measuring a decrease in air flow volume during inhalation with a lung function test. Patients can be effectively treated with thorough differential diagnosis. Medications targeting precipitating factors, physical therapy sessions to improve abnormal larynx movement, counseling to reduce patients'anxiety rising from dyspnea, and etc. can effectively alleviate symptoms.

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Is Voicing of English Voiced Stops Active?

  • Yun, Il-Sung
    • Speech Sciences
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    • v.10 no.2
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    • pp.207-221
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    • 2003
  • Phonetic voicing does not support the phonological distinction of voiced/voiceless in English stops. The present study is aimed at defining the nature of voicing of English voiced stops. A review of the literature reveals that the voicing is position-conditioned and its length is notably inconsistent relative to the closure duration. No consistent relationships are found between vocal fold adduction and glottal pulsing in initial position. Stress reduced the voicing, etc. The hypothesis for experiments was: (1) active voicing: stress generates longer (stronger) voicing during the closure duration of a voiced stop; (2) passive voicing: stress induces shorter (weaker) voicing during the closure. Instead the voiced stop becomes more voiced when the preceding vowel (syllable) is stressed. The literature review and the results of two experiments comparing English and Slovakian suggested that the voicing of English voiced stops is passive (i.e., a coarticulation of glottal pulsing for adjacent vowels-syllables) and should be distinguished from active voicing in some other languages.

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