• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.33-37
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• 1997

Incomplete glottic closure of vocal cord atrophy is the common cause of dysphonia. Patients with vocal cord atrophy have complaints such as dysphonia, vocal fatigue, abnormal sensation in the throat, laryngeal pain, cough or sputum like functional voice disorders. Many investigators could not confirm the pathologic laryngeal structure because of their minute pathology. But recent advancements of laryngeal examinations made the many clinicians to detect minimal laryngeal pathology and to have mind the treatment for the vocal cord atrophy. But the results were less effective than their thoughts, the reasons of ineffectiveness were not known well. Authors have found the Hyperfunctional movement of the supraglottis during phonation before and after thyroplasty type I for vocal cord atrophy. Then we have applied the combined modality treatment with thyroplaty type I and voice therapy for relieve of hypefunctional movement of the supraglottis. These options have had more imporved results.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.6 no.1
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• pp.9-15
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• 1995

Bowing of the vocal cords may be due to aging. atrophy. bilateral superior laryngeal nerve paralysis. injudicious vocal cord surgery, of an idiopathic cause. The bowing usually produces a dysphonia characterized by breathiness due to air escape : however, it can produce aphonia. This report reviews vocal function after surgical correction of bowing of the vocal cords for diagnosis and management. The vocal function of 13 patients with sulcus vocalis and 12 patients with vocal cord atrophy was evaluated with the use of a test battery of multidimensional evaluation items. The voice was improved postoperatively in most patients. The voice improvement was reflected objectively in maximum phonation time, mean air flow rate during phonation, stroboscopic findings. sound pressure level range and fundamental frequency range of phonation, and results of acoustic analyses of tape-recorded voice. The vocal function after surgical correction of the sulcus vocalis and vocal cord atrophy was improved postoperatively in most patient, but the results were not satisfactory.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.2
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• pp.112-117
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• 2013

Background and Objectives : This study aimed to determine the clinical effect of $Artecoll^{(R)}$ injection laryngoplasty for patients with vocal atrophy and mild sulcus vocalis. Materials and Method : Forty-one patients with vocal atrophy and/or mild sulcus vocalis received transcutaneous $Artecoll^{(R)}$ injection into the vocal folds under local anesthesia. Subjective evaluations including voice handicap index (VHI) and perceptual grading with Grade, Roughness, Breathiness, Asthenia, Strain (GRBAS) scales and objective evaluations including jitter, shimmer, noise-to-harmonic ratio (NHR), speaking fundamental frequency (SFF) and maximum phonation time (MPT) were evaluated before and 3 months after the injection. Results : VHI and Grade, Breathiness and Strain scales in GRBAS showed significant improvement 3 months after injection. SFF and MPT also significantly improved after the injection ; MPT increased and SFF in male patients decreased. Conclusion : Injection laryngoplasty with $Artecoll^{(R)}$ is an effective method for correcting the glottal insufficiency and improving voice quality in patients with vocal atrophy and/or mild sulcus.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.1
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• pp.51-53
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• 2003

Amyotrophic lateral sclerosis Is an unusual pattern of distal muscular atrophy with permanent bulbar sign. Vocal fold paralysis and velopharyngeal insufficiency(VPI) due to soft palate paralysis Is occasionally associated with distal muscular atrophy. Recently we experienced a case of amyotrophic lateral sclerosis whose symptom was initially expressed with hoarseness and VPI. So we report a case with review of literature.

• Phonetics and Speech Sciences
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• v.10 no.4
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• pp.163-171
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• 2018

A mixed dysarthria with combinations of hypokinetic, ataxic, and spastic components is a common clinical feature of multiple system atrophy (MSA). Due to the rapid progress of dysarthria after diagnosis, people with MSA experience difficulty with verbal communication, which eventually affects their quality of life negatively. In this study, SPEAK $OUT!^{(R)}$, an intensive 1:1 treatment of dysarthria for improving functional communicative ability, was provided to twelve people with MSA. To evaluate the efficacy of SPEAK $OUT!^{(R)}$ in people with MSA, aerodynamic, acoustic, and perceptual analyses were conducted. Pre-and post-therapy data included maximum phonation time, vocal intensity, and fundamental frequency during /a/ sustained phonation and passage reading; frequency range between high /a/ and low /a/ phonation; jitter, shimmer, and HNR for vocal quality; speech rate during passage reading; and perceptual evaluation scores for articulation precision and intonation. The participants achieved statistically significant improvement in vocal intensity, pitch range, vocal quality, speech rate, and speech intelligibility. In conclusion, SPEAK $OUT!^{(R)}$ is a feasible treatment for people with MSA to efficaciously improve their speech ability.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.7 no.1
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• pp.27-31
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• 1996

The voice of aged persons is known generally to be somewhat different from that of other adults, suggesting that laryngeal change occurs with advancing age. However, because knowledge of the voice characteristics of aged persons is limited, it is difficult to judge whether their voices arc normal. Chart review and laryngoscopic examination from ninety-one patients with hoarseness over the age of 60(1st group) and one hundred sixteen patients with hoarseness below the age of 50(2nd group) were done to define aging related voice disorders. The following results were obtained. 1) Associated diseases related to laryngeal disease were hypertension(12%), pulmonary disease(4.4%), thyroid disease(1.1%) in 1st group and hypertension(9.5%), thyroid disease(1.7%) in 2nd group. 2) The underlying diseases causing hoarseness in order of frequency were benign vocal fold lesion(37.7%), inflammatory disease(36.8%), functional dysphonia(17%) in 1st group and benign vocal fold lesion(43.6%), functional dysphonia(26.3%), inflammatory disease(16.5%) in 2nd group. 3) In stroboscopic findings, atrophy and sulcus of vocal cords are more prevalent in males than in females and edema of vocal cords is more common in females. Generally the voice characteristics of aged persons depend on the mass of the vocal folds which may be decreased through atrophy or be increased by edema. However, other factors such as systemic diseases, drug side effects and compensatory mechanism to presbylaryngis must be taken into account in diagnosing and treating voice disorders in aged persons.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.25-29
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• 2016

Background and Objectives : The clinical reports for the treatment of vocal fold scar and sulcus vocalis are limited, also there is no best one for the treatment of them. This study is to evaluate the effect of Injection laryngoplasty (IL) for the treatment of vocal fold scar and sulcus vocalis. Materials and Methods : from January 2013 to May 2015, the Nineteen patients who were diagnosed as vocal fold scar, sulcus and atrophy, and underwent IL, were engaged in this study. Clinical information and voice parameters were analyzed by retrospective chart review. Pre and post voice parameters were compared. Results : Subgroups of diagnosis were classified into sulcus vocalis for 12 patients, vocal fold scar for 5, and atrophy for 2. IL was performed under local anesthesia through cricothyroid membrane except one patient. Atesense$^{(R)}$, Radiessess$^{(R)}$, and Rofilan$^{(R)}$ were used as injected materials in 9, 9, and 1 patients respectively. Maximal phonation time (p=0.0124), dynamic range (p=0.0028), pitch range (p=0.0141), voice handicap index (p=0.028), glottal closure (p=0.0229), and mucosal wave (p=0.0132) had significant improvement for post-IL voice assessment than Pre-IL. While GRBAS, Mean flow rate, Jitter, Shimmer, Harmony to Noise ratio didn't have improvement. Conclusion : IL is a feasible option for the treatment of glottis incompetence with normally mobile vocal folds such as sulcus vocalis and vocal fold scar.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.44-48
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• 1997

Anatomic and physiological changes of the larynx with advancing age result in morphologic changes of the vocal fold and reduced control of the phonatory mechanism in elderly individuals and are reflected in increased unstability of fundamental frequency (Fo). The purpose of this study is to increase current understanding of acoustic and stroboscopic characteristics of normal elderly persons voices. First, phonated /a/ vowel productions by 40 normal adults (20 to 40 years, 20 men and 20 women) and 40 normal elderly persons (60 to 80 years,20 men and 20 women) were analyzed, using CSL (model 4300B) acoustic analysis software, to obtain acoustic measures related to fundamental frequency stability nd vocal resonance characteristics. Second, stroboscopic images of the vocal fold behavior in all subjects were analyzed by experienced specialists. In the men, fundamental frequency variation (vFe) (p＜0.01), jitter. (p＜0.05), and shimmer (p＜0.05) for the older group were significantly higher than the value for the adult group. In the stroboscopic findings, edema of vocal fold had a significant finding in aged men (15%). In the women, vFo (p＜0.05), jitter (p＜0.05), and noise to harmonic ratio (NHR) (p＜0.05) for the older group were significantly higher than the value for e adult group and first formant frequency (F1) (p＜0.01) and second formant frequency (F2) (p＜0.01) for. the older group were significantly lower than the value for the adult group. In the stroboscopic findings, vocal fold atrophy had a significant finding in aged women (25%). Frequency stability, as reflected by vFo, jitter, shimmer, and NHR, decreases with advancing age in men and women and spectral analysis of phonated /a/ vowel productions reveals the lowering of the frequency of F1 and second F2 with advancing age, especially in aged women. Change in the mass of vocal folds, due to atrophy or edema, is considered to be the greatest factor in these acoustic changes.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.2
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• pp.70-75
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• 2018

The office-based, un-sedated vocal fold injection laryngoplasty has re-emerged in the past decade as an appealing alternative to microsuspension laryngoscopic procedure which is conducted under general anesthesia. The trend toward vocal fold injection laryngoplasty in an in-office setting was possible due to technological evolution for visualization and new injection materials. However, invisibility of the injection needle has been the main shortcomings of cricothyroid approach. The purpose of this review is to provide an up-to-date review of office-based, trans-cricothyroid membrane approach injection laryngoplasty technique under local anesthesia and efforts made to increase the preciseness of amount and location of the injected materials in the management of glottic insufficiency. A review of variable efforts undertaken to maximize the result of cricothyroid approach by technically increasing accuracy of the location of needle tip was done. With the proper patient selection and utilization of the new technologies, office-based and un-sedated vocal fold injection laryngoplasty via cricothyroid approach can be redeem as a main-stay in the management of glottic insufficiency, such as vocal fold paralysis, vocal fold paresis, vocal fold atrophy and vocal fold scar.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.1
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• pp.68-75
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• 2005

The treatment of sulcus vocalis and vocal bowing has been commonly used Thyroplasty Type surgery or injection within vocal folds such as Teflon, silicone, collagen. However, and treatment has not been acquired satisfactory treatment effect. This study was conducted to demonstrate voice therapy effect using singer's vocal technique and respiratory training. 4 patients (1 male, 3 females) with sulcus vocalis or bowing, with or without scar were selected for this study and we compared with acoustic, aerodynamic measures and stroboscopy observation before and after voice therapy. The results showed that 1) case 1 (48yr, male) with sulcus vocalis decreased F0 (Fundamental Frequency), increase CQ(Close Quotient) and high degree of satisfaction but not improved voice quality after voice therapy. 2) case 2(19yrs, femal) with mild sulcus vocalis improved as normal voice quality after voice therapy. 3) case 3(38yrs, female) with functional bowing showed abnormalvocal contact before therapy whereas CQ was increased after voice therapy. 4) case 4(27yrs, female) with vocal atrophy and vocal bowing changed normal range of Fo and increased CQ after voice therapy. Even though contact area of both vocal folds was increased and lowered F0 after voice therapy, current outcomes revealed that normal voice quality was not regained. These results might signify that it was difficult that vocal folds couldn't be recovery of symmetry and viscoelastic property of mucosal wave through voice therapy. However, it was difficult for this study to maintain voice therapy so that evaluate effect of voice therapy for long-term. Further study will be needed to long-term follow-up for voice therapy with these patients.