• 대한후두음성언어의학회지
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• 제30권2호
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• pp.124-127
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• 2019

Vocal fold scarring is an intractable phonosurgical condition. The number of patients with vocal fold scars is increasing with the aging of society and with the increasing application of laryngeal microsurgery. Many methods are available to treat these, including voice therapy, stem cells, regenerative scaffolds, and growth factors. However, no standard treatment strategy has yet been established, and novel techniques are required. Basic fibroblast growth factor has been shown to be effective for the treatment of mild chronic vocal fold scarring. The combined use of basic fibroblast growth factor and regenerative scaffolds is currently under investigation. Here, we report a female patient in whom vocal fold scarring developed after two laryngeal microsurgeries. We performed laryngeal microsurgery to remove the scar tissue and used basic fibroblast growth factor and a collagen scaffold to promote healing. The patient's voice quality was greatly increased, and she was content with her voice after 2 years of follow-up. This is the first report of this methodology in Korea and is presented along with a review of the literature.

• Osong Public Health and Research Perspectives
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• 제9권6호
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• pp.354-361
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• 2018

Objectives: The purpose of this study was to explore the effects of injection laryngoplasty (IL) with hyaluronic acid in patients with vocal fold paralysis (VFP). Methods: A total of 50 patients with VFP participated in this study. Pre- and post-IL assessments were performed, which included analyzing the sustained vowel /a/ phonation, and the patient reading 1 Korean sentence from the "Walk" passage that comprised 25 syllables in 10 words. To investigate the effect of IL on vocal fold function, acoustic analysis (acoustic voice quality index, cepstral peak prominence, maximum phonation time, speaking fundamental frequency) was conducted and auditory-perceptual (grade and overall severity), visual judgment (gap), and self-questionnaire (voice handicap index-10) assessments were performed. Results: The patients with VFP showed statistically significant differences between pre-and post-IL assessments for acoustic and auditory-perception, visual judgment, and self-questionnaire assessments. Conclusion: The patients with VFP showed positive change in vocal fold function between pre- and post-IL measurements. The findings showed that IL with hyaluronic acid is an effective method to improve vocal fold function in patients with VFP.

• 대한후두음성언어의학회지
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• 제11권1호
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• pp.20-27
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• 2000

To determine what is the change of pre and postoperative voice and image analysis parameters and correlations between them, videostroboscopy was analyzed in each 18 patients with unilateral vocal cord paralyses or vocal polyps before and after the surgery from November, 1996 to April, 1999. The correlation between acoustic and aerodynamic parameters was investigated. The software-Videolink and $\pi$-View(Mediface Co, Seoul, Korea)-was used in a quantitative analysis. In unilateral vocal cord paralysis, the glottic angle is well correlated with maximum phonation time, jitter and shimmer preoperatively. The postoperative glottic angle is also correlated with preoperative maximum phonation time. In patients with the vocal polyp, the chink is postoperatively decreased, but the size of the chink and the polyp is not correlated with pre and postoperative voice analysis parameters. These findings reveal that glottic an and vocal fold angle are good indicators of e postoperative glottic configuration in unilateral vocal cord paralysis. Vocal fold ratio is also a useful indicator that represents the length of vocal folds. We consider that the computerized analysis through videostroboscopy is one of objective diagnostic methods in many voice disorders if we can measure a distance between the telelaryngoscope and vocal folds.

• 대한후두음성언어의학회지
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• 제20권2호
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• pp.118-125
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• 2009

Bilateral vocal fold immobility (BVFI) is a challenging condition which may result from diverse etiologies including vocal fold paralysis, synkinesis, cricoarytenoid joint fixation, and interarytenoid scar. Most patients present with dyspnea and stridor, but sometimes with a breathy dysphonia. Careful history taking, laryngoscopic evaluation under general anesthesia or awaken status, laryngeal EMG, and imaging studies with CT and/or MRI are helpful for providing a precise diagnosis and planning appropriate managements. In children, congenital neurological disorder is one of the most common etiologies, and spontaneous recovery has been reported in more than 50% of cases. Therefore, observation for more than 6 months while securing the upper airway with tracheostomy if needed is a generally accepted rule before deciding any destructive procedure to be undertaken. In children with advanced posterior glottic stenosis, laryngotracheal reconstruction with rib cartilage graft should be considered. In contrast to children, BVFI most commonly occurs as sequalae of surgical complication in adults. Diverse static or dynamic procedures can be applied; posterior cordotomy, vocal fold lateralization, endoscopic or open arytenoidectomy, arytenoid abduction, and reinnervation, electrical laryngeal pacing, which need to be carefully selected according to each patient's needs and pathophysiology of BVFI.

• 대한후두음성언어의학회지
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• 제8권1호
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• pp.18-26
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• 1997

There are two types of phonetic study, acoustic and physiologic, for differentiating the three manner categories of Korean stop consonants. On the physiologic studies, there are endoscopic, electromyographic(EMG), electroglottographic(EGG) and aerodynamic studies. In this study, I tried to investigate general features of Korean stops using EGG study for the open quotient of vocal fold and baseline shift during speech, and aerodynamic characteristics for e subglottal air pressure, air flow and glottal resistance at consonants. On the aerodynamic study, the glottalized and aspirated stops may be characterized by e increasing subglottal pressure comparing with lenis stop at consonants. The airflow is largest in the aspirated stops followed by lenis stops and glottalized. The glottal airway resistance (GAR) showed highest in the glottalized followed by the lenis, but lowest in e aspirated during e production of consonants, and showed highest in e aspirated, but low in the glottalized and lenis during the production of vowel. The glottal resistance at consonant showed significant difference among consonants and significant interaction between subject and types of consonant. The glottal resistance at vowel showed significant difference among consonants, and e interaction occured between subject and types of consonant. The electroglottography(EGG) has been used for investigating e functioning of e vocal folds during its vibration. The EGG should be related to the patterns of the vocal fold vibration during phonation in characterizing the temporal patterns of each vibratory cycle. The purpose of this study is to investigate the dynamic change of EGG waveforms during continuous speech. The dynamic changes of EGG waveforms fir the three-way distinction of Korean stops were characterized that the aspirated stop appears to be characterized by largest open quotient and smallest glottal contact area of the vocal folds in e initial portion of vocal fold vibration ; the lenis stop by moderate open quotient and glottal contact area ; but the glottalized stop by smallest open quotient and largest glottal contact area. There may be close relationship between the OQ(open quotient) in the initial voice onset and the glottal width at the time of consonant production, the larger glottal width just before vocal fold vibration results in the smaller OQ of the vocal fold vibration in the initial voice onset. The EGG changes of baseline shift during continuous speech production were characterized by the different patterns for the three types of Korean consonants. The small and less stiffness change of baseline shift was found for the lenis and the glottalized, and the largest and stiffest change was found for the aspirated. On the baseline shift for the initial voice onset, they showed so similar patterns with for the consonant production, larger changed in the aspirated. for the lenis and the glottalized during the initial voice onset, three subjects showed individual difference each other. I suggest at s characteristics were strongly related with articulatory activity of vocal tract for the production of consonant, especially for the aspirated stop. The suspecting factors to affect EGG waveforms are glottal width, vertical laryngeal movement and the intrapharyngeal pressure to neighboring tissue during connected spech. So the EGG may be an useful method to describe laryngeal activity to classify pulsing conditions of the larynx during speech production, and EGG research can be controls for monitoring the vocal tract articulation, although above factors to affect EGG would have played such a potentially role on vocal fold vibratory behavior obtained using consonant production.

• 대한두경부종양학회지
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• 제33권2호
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• pp.55-58
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• 2017

Background. Lymphoma of the vocal fold is extremely rare due to low lymphoid content in the larynx. To date, fewer than 100 cases of laryngeal lymphoma have been reported; however, none of these literatures are concerned about exclusive laryngeal involvement of recurred lymphoma which initially appeared in other body sites. Specific consensus about management for these patients yet to exist, due to its rare occurrence; however, the main modality of treatment is chemotherapy alone or in combination with radiation therapy. Case. Herein, we report a case of a 51-year-old female patient who had recurrent T-cell lymphoma developing in bilateral vocal folds. The patient was originally diagnosed of T-cell lymphoma in right colic flexure 10 years ago, and was cured by chemotherapy. Immunohistochemical stain revealed the histologic type of recurred tumor in the vocal folds that are identical to the previously cured lymphoma. Conclusion. To the best of our knowledge, this was the first case that recurrent lymphoma occurred solely in the vocal folds. Despite its rarity, lymphoma should be put in the index of suspicion among those patients with decreased vocal fold mucosal wave without definite vocal fold mass who had a history of cured lymphoma.

• 대한후두음성언어의학회지
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• 제30권1호
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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.

• 대한후두음성언어의학회지
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• 제18권1호
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• pp.56-61
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• 2007

Introduction: Actually classification of classic singers' voice depends on habitual judgment by voice teachers or voice trainer referring to vocal timbre, vocal range and vocal quality. Such judgments, however, may turn out to be incorrect because they are based on subjective opinions. Therefore, more objective methodology is required. Method: Foreign dissertations searched through Pub Med, along with foreign and domestic journals, were reviewed regard ing how singers' voice has been categorized. Results: Vocal range, vocal timbre, voice quality, fundamental frequency of habitual speaking, length of vocal tract, the length from cricoid cartilage to thyroid cartilage's thyroid notch and length of vocal fold, tone of passaggio as well as traditional approaches such as perceptual judgment used by professional singers have been used for categorize the voice classification. Conclusion: To optimize categorizing singers' voice, vocal range, vocal timbre, voice quality, fundamental frequency of habitual speaking, length of vocal tract, the length from cricoid cartilage to thyroid cartilage's thyroid notch and length of vocal fold, tone of passaggio may be totally recommended.

• 대한후두음성언어의학회지
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• 제28권2호
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• pp.84-88
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• 2017

Background and Objectives : The purpose of this study was to compare the usefulness of Cepstral peak prominence (CPP) with parameter of Multiple Dimensional Voice Program (MDVP) in evaluating unilateral vocal fold paraylsis patients with subjective voice impairment. Materials and Methods : From July 2014 to August 2016, 37 patients with unilateral vocal fold paralysis who had been diagnosed with unilateral vocal fold paralysis and had received two or more voice tests before and after the diagnosis were evaluated for maximum phonation time (MPT), MDVP and CPP. Respectively. Voice tests were performed with short vowel /a/ and paragraph reading. Results : The CPP-a (CPP with vowel /a/) and CPP-s (CPP with paragraph reading) of the Cepstrum were statistically negatively correlated with G, R, B, and A before the voice therapy. Jitter, Shimmer, and NHR of MDVP were positively correlated with G, R, B. Jitter, Shimmer, and NHR of the MDVP were significantly correlated with the Cepstrum index. G, B, A and CPP-a and CPP-s showed a statistically significant negative correlation and a somewhat higher correlation coefficient between 0.5 and 0.78. On the other hand, in MDVP index, there was a positive correlation with G and B only with Jitter of 0.4. Conclusion : CPP can be an important evaluation tool in the evaluation of speech in the unilateral vocal cord paralysis when speech energy changes or the cycle is not constant during speech.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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• 제61권11호
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• pp.619-623
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• 2018

Mucosal bridges of vocal fold have been described as a parallel band to vocal folds with the presence of sulcus vocalis. However, the type of mucosal bridge crossing each vocal fold has not been well documented in the literature. Herein, we present two cases of mucosal bridge found in the vocal fold connecting the mid-portions of true vocal folds. Two patients who had no history of laryngeal trauma, surgery or oro-tracheal intubation visited our clinic due to voice change. Laryngoscopic examination revealed that they had a mid-portion mucosal band without any other mucosal lesions. Two patients underwent laryngomicrosurgery with pulsed dye laser. After the surgery, they showed significant improvement of voice quality.