• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.82-86
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• 2019

In the field of otolaryngology-head and neck surgery, botulinum toxins are widely used for the treatment of spasmodic dysphonia and vocal tremors. Recently, the applications of botulinum toxin have gradually expanded with time, to include vocal fold granuloma, mutational falsetto, bilateral vocal cord paralysis, and chemical reduction for arytenoid dislocation as an adjunctive modality. According to a nation-wide multicenter study conducted by the Korean Society of Laryngology, Phoniatrics and Logopedics for treatment modality of contact granuloma, among the various treatment modalities, botulinum toxin injection showed the highest response rate and lowest recurrence rate in both primary and refractory cases. Therefore, botulinum toxin could be reserved as a second-line treatment for contact granuloma in which the first treatment was not effective, but also could be used as a first-line treatment depending on the patient's and institution's situation. For recalcitrant nodules, injection of botulinum toxin into the bilateral thyroarytenoid muscle will reduce glottal contact force and result in a forceful chemical voice rest. In special situations, botulinum toxin injection could be one of the alternative treatment options for recalcitrant vocal nodules.

• Speech Sciences
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• v.13 no.3
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• pp.133-149
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• 2006

This study attempted to compare acoustic parameters, physiological observation and perceptual evaluation values obtained from the treatment and control groups in order to find out which of the self voice feedback therapies was better and which methods to train them were more effective. The experimental group carried out various self voice feedback therapies while the control group did only vocal hygiene. The acoustic measurement and voice manipulation for providing the patients visual, auditory feedback were done by a speech analysis software, Praat. The authors designed vocal hygiene, abdominal respiration and Praat self voice feedback therapies and applied them to 15 patients while applying only one vocal hygiene to 15 of the control group. For the purpose of examining the degree of their voice improvement after the treatment, pre- mid- and final evaluations were made for the two groups at the beginning, the 6th week and immediately after the 8th treatment session. Results of this study were as follows: The treatment group showed much improvement after receiving the voice treatment. In particular, acoustical and physiological indices from the optical endoscopy, pitch variation(Jitter), amplitude variation (Shimmer), maximum phonation time(MPT), and psychoacoustic evaluation showed statistically significant improvements over the control groups.

• Phonetics and Speech Sciences
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• v.1 no.2
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• pp.31-36
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• 2009

This study attempted to examine the effects of a portable voice feedback device on the hyperfunctional voice behaviors of children with vocal nodules when they wore the device in their daily lives. The device could set fundamental frequency and intensity at optimal levels for the subjects, It produces an audible alarm for inappropriate hyperfunctional voices beyond the preset levels, In addition, the frequency of hyperfunctional voice behaviors was recorded by the device, therefore the users were able to chart their number of hyperfunctional voice behaviors per day, According to results acquired after having subjects wear the device for 12 weeks, the subjects' frequency of hyperfunctional voice behaviors decreased significantly (p < .01). Especially from the first to fourth week, the frequency of their hyperfunctional voice behaviors declined significantly.

• Kosin Medical Journal
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• v.33 no.2
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• pp.252-256
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• 2018

We report a case of difficult endotracheal intubation in a patient with tracheobronchopathia osteochondroplastica. A 65-year-old man was scheduled to undergo ulnar nerve decompression and ganglion excisional biopsy under general anesthesia. During induction of general anesthesia, an endotracheal tube could not be advanced through the vocal cords due to resistance. A large number of nodules were identified below the vocal cords using a $Glidescope^{(R)}$ video-laryngoscopy, and fiberoptic bronchoscopy revealed irregular nodules on the surface of the entire trachea and the main bronchus below the vocal cords. Use of a small endotracheal tube was attempted and failed. a laryngeal mask airway (LMA $Supreme^{TM}$) rather than further intubation was successfully used to maintain the airway.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.1
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• pp.40-44
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• 2002

Background and Objectives : Vocal abuse and misuse and muscle tension dysphonia that have various movements of false vocal folds may be related to the development of benign vocal folds lesions, such as vocal nodules, polyps, and cysts. This study was designed to determine whether benign vocal folds lesions were related with movements of false vocal folds on phonation. Material and Methods : One Hundred and seventy eight subjects were studied. All subjects received otolaryngological evaluation including videostroboscopy, objective voice measures. Patients were diagnosed as normal shape of vocal folds (group a), approximation of bilateral false vocal folds (group b), approximation of unilateral false vocal folds (group c), lateralized extension of false vocal folds (group d), and medialized approximation of posterior false vocal folds (group e). We analyzed the results of benign vocal folds lesions in each group. Results : Differences were found between the normal shaped group and the abnormal shaped group. No differences were found between each abnormal groups except group d and e. Conclusion : The shape of false vocal folds was related to the benign vocal folds lesions.

• 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.

• 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.26 no.2
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• pp.94-96
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• 2015

Several distinct pathologic entities are encompassed in benign vocal fold lesions, including intracordal cysts, vascular ectasia, as well as vocal fold nodules and vocal fold polyps. Treatment options for theses lesions include both medical/conservative and surgical techniques. First approaches should be focus on correcting the underlying causative factors, largely through voice therapy and education. There are several laryngomicrosurgery techniques for removal of benign lesions. Much debate continues regarding the relative merits of cold instruments versus carbon dioxide laser removal of benign vocal fold lesions. Both techniques have the merits and the demerits each other. Therefore the surgeon should well comprehend the merits of each techniques and choose the proper procedure for patient's lesions.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.97-100
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• 2015

Benign vocal fold lesions, such as vocal nodules, polyps and Reinke's edema, usually result from chronic voice overuse. Conservative management such as voice therapy and pharmacotherapy are used as the primary treatment techniques. The main purpose of voice therapy is to identify and reduce voice misuse to achieve the optimal voice. But complete resolution may not be possible in all patients after voice therapy. Furthermore, some patients with voice-related occupations, voice rest and voice therapy are sometimes difficult, which makes it hard to carry out the treatment. When conservative therapy is ineffective, laryngeal microsurgery can be performed under general anesthesia. However, potential complications following laryngeal suspension and violation of the layered structure of the vocal fold during surgery should be considered before surgery. In recent decades, emerging literatures have demonstrated the potential usefulness of vocal fold steroid injection as an alternative treatment option for benign vocal fold lesions. The most advantageous feature of vocal fold steroid injection is the maintenance of regional anti-inflammatory effects while preventing the potential systemic adverse effects of the steroid. Many non-surgical treatment methods can be conducted using different approaches in the office setting. It can be applied as an alternative treatment modality for the management of various benign vocal fold lesions.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1978.06a
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• pp.6.4-7
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• 1978

The author has experienced 50 cases of vocal nodules and polyps in our department for 3 years from May 1974 to April 1977. These nodules were removed out with laryngeal forcep under indirect laryngoscopy and maximum phonation time and timbre of the voice were analyzed before and after operation. Very shortened phonation time of the patient with vocal nodule has returned to normal range (Male : 30 seconds, Female: 20 seconds) and the voice timbre has recovered to almost normal voice postoperatively. The author has made a brief literature review.