• 제목/요약/키워드: Vocal Polyp

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외래에서 시행되는 585 nm 펄스다이레이져 후두수술 (Office-Based 585 nm Pulsed Dye Laser(PDL) Laryngeal Surgery)

  • 김형태
    • 대한후두음성언어의학회지
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    • 제20권1호
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    • pp.25-30
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    • 2009
  • Introduction: 585 nm Pulsed dye laser (PDL) laryngeal surgery is based on the photodynamic characteristics of selective photothermolysis and photoangiolysis and recently considered to be the treatment for a variety of benign laryngeal disease. Objective: To review the indications and outcome of office-based 585nm PDL surgery and summarize new developments. Method: Retrospective study involving 402 patients was performed, The PDL surgery could be applied to various laryngeal diseases such as laryngeal papilloma, vocal fold dysplasia, laryngeal granuloma, vocal polyp, capillarectasia, scarred vocal fold and sulcus vocalis. Results : The physiologic properties of the vascular specificity of PDL provide many advantages and appear to be effective for laryngeal treatment. The PDL resulted in precise, selective coagulation of the microvasculature without damage to the surrounding tissue. Therefore PDL surgery is safe and effective for office-based treatment of benign laryngeal disease and for all patients regardless of their overall medical condition. Conclusion: PDL surgery provides potential benefits and advantage for treating common benign laryngeal disease.

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양성성대질환에서의 발성시작유형에 관한 연구 (The Study for Voice Onset Types in Benign Vocal Fold Lesions)

  • 김성태;안철민;남순열
    • 대한후두음성언어의학회지
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    • 제20권2호
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    • pp.131-135
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    • 2009
  • Background and Objectives: Benign vocal fold lesions have shown various voice onset types on phonation, however, they have not been documented yet. We studied to know the relationships between benign vocal fold lesions and voice onset types. Materials and Method: 114 subjects were evaluated by using videokymographic examinations. The subjects were classified into three types: normal, contact, and open types according to the patterns of voice onset types on phonation. Benign vocal fold lesions were investigated and voice onset types were compared between normal and disease groups. Voice parameters were obtained from and compared in all subjects to assess acoustic and aerodynamic factors. Results: The normal type among onset types were more than contact type or open type in both normal and disease groups. Disease group showed many contact and open types when. compared with normal group. Vocal nodule and vocal polyp were showed many normal and contact types, however, sulcus vocalis was almost showed open type among voice onset groups. The values of mean flow rate (MFR) of contact type were significantly higher compared to normal type in disease group (p<0.05). Shimmer of contact type was higher than normal type in diseasegroup, but the difference was not significant (p=0.057). Conclusion: Benign vocal fold lesions were related to the various types of voice onset. The various types of voice onset should be considered when benign vocal fold lesions were examined.

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성대낭종환자에서의 후두미세수술전후의 음성언어분석비교 (Voice Analysis and Videostroboscopic Findings before and after Laryngomicrosurgery of Intracordal Cysts)

  • 고윤우;배정호;윤현철;정태영;김광문;최홍식
    • 대한후두음성언어의학회지
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    • 제11권1호
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    • pp.12-19
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    • 2000
  • Background and Objectives : Dysphonia may be secondary to many different type of benign vocal cord lesions such as vocal polyp, vocal nodule, Reinke's edema, and intracordal cyst. Diagnosis and treatment of intracordal cysts are more difficult than other benign vocal cord lesions. But postoperative voice analysis of intracordal cyst have rarely been reported in the literature. The purpose of this study is to analyze aerodynamic and acoustic results and videostroboscopic findings before and after laryngomicrosurgery. Materials and Methods : We reviewed the pre and post-operative voice analysis results and videostroboscopic findings of 15 surgically treated patients of intracordal cysts at Severance hospital from Jun. 1997 to Nov. 1999 retrospectively. They were diagnosed with videostroboscopic findings, surgical findings, and pathologic reports. Their pre and post-operative speech were analyzed with MDVP(Multi Dimension Voice Analysis Program) of CSL(Computerized Speech Lab) and Aerophone II. Their pre and post-operative mucosal wave of true vocal cord was analyzed with videostroboscopy. In order to compare this results with normal group, 10 of normal persons were evaluated with same methods. Results : After the operation, mucosal wave of true vocal cord was improved in all patients. Postoperative acoustic and aerodynamic results were improved in almost parameters, but they did not reach the normal value. Conclusions : Videostroboscopy was essential in diagnosing intracordal cysts. By comparing the acoustic and aerodynamic results and video-stroboscopic findings before and after the laryngomicrosurgery, postoperative vocal function was defined more accurately and objectively. Almost parameters may be useful in assessing the quantitative changes in vocal quality before and after the laryngomicrosurgery.

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KTP-532 레이저를 이용한 후두미세음성수술의 임상적 적용 결과 (KTP-532 Laser Microlaryngeal Phonosurgery)

  • 최종욱;주형로;정광윤
    • Archives of Reconstructive Microsurgery
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    • 제2권1호
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    • pp.62-69
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    • 1993
  • Recently, conservative and bloodless operative procedures have been focused, so that endoscopic laser have been used. However application of endoscopic laser surgery for laryngeal lesion is capable for followings: (1)capability of delivery through an operating microscope, (2) vaporization of ultraspot. $CO_2$ laser which has been used, has limitations for voice improvement because of 700 micron beam spot. KTP-532 laser which is capable of delivery through an operating microscope vapore 200 micron ultraspot has developed and applied to microlaryngeal surgery. We have experienced 60 cases who were contracted with hoarseness(53 cases of benign lesions vocal nodule 13, vocal polyp 13, bilateral diffuse polyposis of vocal cords 11, intracordal cyst 8, vocal papilloma 5, laryngocele 1, laryngeal stenosis 2 and 7 cases of malignant lesions : laryngeal carcinoma stage I and II) since 1991. We operated them with KTP-532 Laserscope(3 Watt/0.05 sec., pulsed or continuous. San Jose, Calif, USA). Forty eigh cases(90.6%) of 53 bengin laryngeal lesions and 4 cases(57.1%) of malignant lesions were significantly improved in their voices. There were a few complications and technical problems, but laser surgery alone had a limitation to eradicate the disease.

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성대 결절 및 폴립 병변 판별 예측모형에 대한 연구 (A Study of the Lesional Grade Discrimination Model for Vocal Fold Nodules and Polyps)

  • 박수정;심현섭;정성민;김한수;박애경
    • 대한후두음성언어의학회지
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    • 제15권2호
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    • pp.112-117
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    • 2004
  • Background and Objectives : This study is purposed to investigate the statistically significant discrimination model for predicting vocal fold nodule and polyp's lesional grade, with patients' background data and objective voice evaluation parameters. Materials and Method : The retrospective research was carried out at the Ewha Womans University Hospital. 122 patients' voice examination data had been selected, and lesion screening (Grade I, II, and III) was conducted by 2 ENT specialists, with each patient's vocal fold pictures achieved during the laryngoscopy examination. Results : The Lesional Grade Discrimination Model with which the lesional grade of vocal fold nodules and polyps could be predicted was derived by the ordinal logistic regression analysis (using SPSS 10.0). With this model the lesional grades of 73 out of 122 patients(59.8%) were correctly predicted to their formerly screened ones. Conclusion : This model applied the multivariate approach, which statistically combined these currently used parameters, Jitter, Shimmer, MFR, MPT, and patient's background data such as gender and dysphonia period. It might explain the status of benign lesion of vocal folds, and furthermore expect the physiological function of vocal folds.

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사성을 주소한 이비인후과 질환에 대한 임상적 관찰 (A Clinico-Statistical Analysis of Patient with Hoarseness in E.N.T. field)

  • 이숙자;강영;유방환
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1977년도 제11차 학술대회연제 순서 및 초록
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    • pp.6.2-7
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    • 1977
  • 사성은 후두의 정상 발성기능이 장애되있을때 생기며, 후두질환의 가장 중요하고 특유한 증상이다. 1885년 Morgagni가 최초로 후두암에 대해서 보고한 이래 최근 후두암에 대한 인식이 높아짐과 동시에 사회적으로 날로 심각한 문제가 되고 있는 공해 특히 대기오염으로 인한 기도증상으로 야기되는 후두질환증후인 사성을 호소하는 환자들이 증가되고 있는지 연구 고찰함이 의의가 있다고 생각되어, 저자들은 1970년 1월부터 1976년 12월까지 만 7년간 한일병원 이비인후과 외래에 사성을 주소로 내원한 400명의 환자에 대한 임상적 고찰을 하여 다음 몇가지 지견을 얻었기에 문헌적 고찰을 가하여 보고하는 바이다. 1. 이비인후과 신 외래환자 총 14,731명중 사성 환자가 400명으로 약 2.7%이였다. 2. 성별로는 남여비가 211 : 189로 약 1.1 : 1로써 남子가 약간 많았다. 3. 질환별로는 급성후두염 158례(39.5%). 만성후두염 103례(27.3%), 성대결절 37례(9.3%), 성대마비 34례(8.5%), 성대 polyp 32례(8%), 후두질 13례(3.25%), 후두결핵 9례(2.25%)의 순이었다. 4. 연령별로는 30세대가 113례(28.23%)로 가장 많았고 다음으로 40대, 20대, 순이였으며, 10대, 20대, 60대 이상은 비교적 저율이였다. 5. 성별질환분포는 후두암이 12 : 1, 후두polyp 27 : 5, 후두유두종 4 : 1로 남성에서 압도적으로 많았으며, 그 외질환은 남여 비슷한 율을 보였다. 6. 연령별질환분포는 50세대까지는 급만성후두염이 가장 많았고 30대에선 후두 polyp, 30대 및 40대에선 성대결절, 40대 및 50대에선 후두결핵과 성대미비, 50 대에서는 후두암이 최고율이였다. 7. 월별분포는 고루 산재되어 있었으며 그중 3월∼6월사이가 비교적 고율이었고 동절엔 비교적 낮았다. 8. 발병부터 초진까지의 기간은 10일이내가 103례(26%)로 가장 많았고 약 80%에서 발병 1년이내에 내원하였다.

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Dr. Speech Science를 이용한 정상 및 후두질환 환자의 음향분석 (Acoustic Analysis of Normal and Vocal Pathologic Voice Using Dr. Speech Science)

  • 이형석;태경;장경진;김경우;김경래;박철원
    • 대한후두음성언어의학회지
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    • 제8권2호
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    • pp.166-172
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    • 1997
  • Background : For example, aerodynamic study, vibratory study, acoustic study, neuro-muscular test and psychoacoustic evaluation, a number of objective methods are now available for assessing pathologic voice change. They help to differentiate pathologic condition from normal condition and to monitor pathologic and aging change. These laboratory analyses are used commonly to monitor speech therapy and to follow a patient's recovery after surgery. Objectives : We investigated the values of jitter, shimmer and NNE of normal person and hoarseness patients in Korea. The values of Jitter and shimmer might be meaningful parameters distinguishing pathologic vibration from normal and recovery after surgery. Materials and Methods : Statistical significance between normal control and 48 subjects taken microlaryngeal surgery were compared with Dr. speech science program that is computerized system for acoustic analysis of voice production employed to determine vocal characteristics of pitch perturbation(jitter) and amplitude perturbation(shimmer). Results : The mean normal values of jitter and shimmer were 0.226${\pm}$0.110(%), 2.200${\pm}$0.421(%) in male and 0.164${\pm}$0.060(%), 2.063 ${\pm}$0.575(%) in female. In patients with vocal nodule, the preoperative and postoperative values of jitter and shimmer were valueless. In patients with vocal polyps, the preoperative and postoperative values of jitter and shimmer were valuable. Conclusion : Dr. speech science program was effective to monitor laryngeal disease and aging changes.

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양성후두 질환 음성에 대한 여러 기존 피치검출 알고리즘의 성능 평가 (Performance Assessment of Several Established Pitch Detection Algorithms in Voices of Benign Vocal Fold Lesions)

  • 장승진;최성희;김효민;최홍식;윤영로
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 2007년도 하계종합학술대회 논문집
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    • pp.407-408
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    • 2007
  • Robust pitch estimation is an important study in many areas of speech processing. In voice pathology, diverse statistics extracted form pitch were commonly used to test voice quality. In this study, we compared several established pitch detection algorithms (PDAs) for verification of adequacy of the PDAs. In the database of total pathological voices of 99 and normal voices of 30, an analysis of errors related with pitch detection was evaluated between pathological and normal voices, or among the types of pathological voices such as benign vocal fold lesions; polyp, nodule, and cysts. Consequently, it is required to survey the severity of tested voice in order to obtain accurate pitch estimates.

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정상인과 후두폴립환자 음성의 음향적 분석 (Acoustic measures from normal and vocal polyp patients)

  • 최흥식;장미숙;이정준
    • 대한음성언어의학회:학술대회논문집
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    • 대한음성언어의학회 1993년도 제1회 학술대회 연제순서 및 초록집
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    • pp.15-15
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    • 1993
  • 정상 성대는 규칙척인 진동을 보이지만 병변이 있는 사람들은 진폭과 시간에 있어서 주기마다의 불규칙성을 보여준다. 이 때 각 주기마다의 시간의 불규칙성은 Jitter를 의미하며 강도의 불규칙성은 Shimmer로 표현된다. 본 연구는 우리나라 정상인 음성의 떨림을 객관적으로 조사해보고 이에 따라 병변이 있는 사람들의 음성의 떨림을 판별할 수 있는 가능성을 알아보기 위하여 저자들은 CSpeech를 이용해 정상인과 후두폴립환자의 jitter, shimmer, S R를 비교해보았다.(중략)

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성대 폴립 환자를 대상으로 한 GRBAS 척도와 MDVP 측정치 간의 상관관계 연구 (The Correlation between GRBAS Scales and MDVP Parameters on the Pathologic Voices of the Patients with Vocal Polyps)

  • 표화영;최성희;임성은;심현섭;최홍식;김광문
    • 대한후두음성언어의학회지
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    • 제10권2호
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    • pp.154-163
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    • 1999
  • GRBAS scale, the tool fir the perceptual evaluation of voice, demands the experience of judges, and MDVP parameters of CSL, the tool for the objective measurements of voice quality demands the exact interpretation of the analyzed results. The two tools should be used as compensatory evaluation methods, so the experimental study was performed to investigate the correlation between GRBAS scales and MDVP parameters by using the pathologic voice of the 30 patients with vocal polyps, and to know the significant MDVP parameters which the inexperienced GRBAS scale judges should attend to. The 30 subjects voices, saved in MDVP of CSL were analyzed by its own analysis program, and three experienced voice therapists judged the same voices by using GRBAS scales. The correlations between them were analyzed by Spearman Rank Correlation Coefficient. As results, among the 29 MDVP parameters, 22 parameters showed statistically significant correlation with Grade(G) scale(p<0.05). And it was found that Roughness(R) scale showed significant correlation with 18 parameters, Breathiness(B) scale with 17 parameters, Strain(S) scale with 12 parameters. In Asthenicity(A) scale, no parameter showed significant correlation. On the whole, significantly high correlation were found in the parameters related with pitch ind amplitude perturbation, especially, the amplitude perturbation.

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