• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.6 no.1
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• pp.5-8
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• 1995

Bilateral vocal cord palsy is uncommon but is serious because of airway obstruction. Treatments of bilateral vocal cord palsy are initially tracheotomy, vocal cord lateralization and vocal cord reinnervation. Recently, we experienced nerve-muscle pedicle reinnervation in 3 cases of bilateral vocal cord palsy, so reported it with a review of literature.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.75-81
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• 1997

The clinical investigation was done in the 42 patients with bilateral vocal cord palsy who visited the otorhinolaryngologic department of the Yongdong Severance Hospital during the 10-year period between August 1986 to August 1996. On the sex and age distribution, the ratio of male to female patients was 2.8 : 1 and the age was evenly distributed and average was 46 years old. Of their chief complaints, dyspnea was the most common symptom. Among the position of the paralyzed vocal cords, paramedian position was most common. The most common causes of the bilateral vocal cord palsy was idiopathic Other causes include iatrogenic, prolonged intubation, head ＆ neck trauma, brain tumor, Myasthenia Gravis, and mediastinitis. Our treament results were as follows. Recovery rate of idiopathic bilateral vocal cord palsy was 77.7% and recovery period after bilateral vocal cord palsy was shortened remarkedly after use with steroid. We performed laser arytenoidectomy in patients with irreversible idiopathic vocal cord palsy, neural injury, and cricoarytenoid joint fixation. Decannualtion was possible to be carried out in 86% of the patients and none of complication except for 1 case of aspiration developed. Thus we concluded that it was meaningful surgical treatment of bilateral vocal cord palsy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.188-192
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• 2002

Unilateral vocal cord palsy which is associated with laryngeal trauma is not uncommon event. In a 42-year-old male, a cricoid cartilage fracure had been developed after blunt trauma. The endoscopic findings showed contusion and diffuse swelling around the left arytenoid and false cord. During phonation, the mobility of left side true vocal cord was decreased. There were no level difference and displacement of the left side arytenoid. We used the laryngeal electromyography (LEMG) to make a differential diagnosis between the cricoarytenoid joint dislocation and the injury of recurrent laryngeal nerve. At the right thyroarytenoid muscle and cricothyroid muscle, the findings of LEMG were normal. But the amplitude and frequency during phonation were decreased (partial denervation) at the left thyroarytenoid muscle. LEMG is a very useful method to predict the diagnosis of vocal cord palsy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.66-70
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• 1998

Background and Objectives : The managements of unilateral vocal cord palsy include type Ⅰ thyroplasty and arytenoid adduction. One type operation has been shown no satisfactory effect. We evaluated preoperative and postoperative speech of unilateral vocal cord palsy patients who received combined operation of type Ⅰ thyroplasty and arytenoid adduction to help for the management plan of unilateral vocal cord palsy patients. Materials and Methods : We reviewed the postoperative results and complication of 17 surgically treated patients of unilateral vocal cord palsy at Severance hospital from Nov. 1996 to Dec. 1997 retrospectively. They were received combined operation of type Ⅰ thyroplasty and arytenoid adduction. Their pre and post-operative speech were analyzed with MDVP(Multi-Dimension-Voice analysis Program) of CSL(Computerized Speech Lab). Results : After the operation, MPT(Maximal Phonation Time) was increased and MFR(Mean Flow Rate) was decreased in all patients. NHR(Noise to Harmonic Ratio) and VTI(Voice Turbulence Index) were decreased : liner, RAP(Relative Average Perturbation Quotient), PPQ(Pitch Period Perturbation Quotient), sPPQ(smoothed Pitch Period Perturbation Quotient), vFo(fundamental frequency Variation) were decreased : Shimmer, APQ(Amplitude Perturbation Quotient), sAPQ(Smoothed Amplitude Perturbation Qoutient), vAm(Peak Amplitude Variation) were decreased in all the patients. Conclusions : In unilateral vocal cord pals), combined operation of type Ⅰ thyroplasty and arytenoid adduction could obtain satisfactory postoperative voice. MDVP has many parameters and good method for evaluation of voice surgery.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.112-116
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• 2015

Background and Objectives : Aerodynamic analysis is an examination which provides information regarding various vocalization measures indicating laryngeal efficiency. Voice evaluation using such examination must be capable of distinguishing between normal to abnormal voice. It also observes variables on aerodynamic characteristics by gender in regards to patients of vocal disorders, especially of vocal cord paralysis and vocal polyp, and compares the conditions before and after surgery. This paper therefore, seeks to build a framework for establishing standard levels of aerodynamical characteristic on vocal disorders. Subjects and Methods : The study was intended for a total number of 20 patients with vocal polyp or unilateral vocal cord paralysis. Those with the vocal polyp underwent laryngomycroscopy surgery and the vocal cord paralysis, vocal fold injection using Restylane. Aerodynamic analysis fulfilled the Maximum sustained Phonation (MXPH) and Voicing Efficiency (VOEF) by using PAS Model 6600 (KayPENTAX, USA). Results : In MXPH, increase in PHOT were evident with vocal polyp after surgery. As for patients with vocal cord paralysis, MAXDB, MEADB, DHODB, PHOT all have increased and MEAP, PEF, MEAF decreased after surgery. In VOEF, patients with vocal cord paralysis who underwent surgery showed increase in MAXDB, MEADB, DHODB, FET100, ARES, but decreases in PEF, TARF. Conclusion : Overall, it can be concluded that patients with the vocal polyp and vocal cord paralysis seemed to get closer to the normal values after than before surgery in majority of measures. This confirms that the function of their vocal cord has improved nearly to normality through operations.

• Korean Journal of Bronchoesophagology
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• v.19 no.1
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• pp.5-10
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• 2013

Bilateral vocal cord palsy (BVCP) present a challenging condition which result from various etiologies including iatrogenic recurrent laryngeal nerve injury, progressive neurological disorder, intubation, trauma, tumor and idiopathic cause. Careful history taking, laryngoscopic evaluation, laryngeal EMG, and imaging studies are helpful for providing a precise diagnosis and planning appropriate treatment. BVCP causes airway restriction and not vocal dysfunction. In patients with BVFP, treatment is directed at maximizing the airway, while attempting to limit the negative effects of treatment on vocal function. A variety of surgical procedures are available for mangement of BVCP. The most conservative, limited procedure should be selected initially, and then further surgery and more extensive surgery can be tailored to the patient's airway and voice needs. This review will address the etiology, diagnosis, and managements of BVCP.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.1
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• pp.17-23
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• 1999

Vocal hyperfunction is considered to be the most significant characteristic in larynx disorders which is found among many patients presenting hoarseness Primarily as chief complaint. In Pusan National University Hospital, we executed the voice therapy to 28 patients being 17 female and 11 male patients who visited the Voice ＆ Speech Therapy Clinic, due to the voice disorder, and then compared and analysed the voice before and after its therapy using acoustic and aerodynamic test. The obtained results were as follows. In the analysis by the local findings, it was improved to 88% in the patients of vocal nodule, 75% in mutational falsetto, 75% in the functional dysphonia, 75% in the vocal cord palsy, 50% in the vocal polyp and 50% in dysphonia plica ventricularis. For the acoustic analysis, Fo, litter, Shimmer and NHR were measured. In the patients of mutational falsetto, Fo, Jitter and NHR were shown to be improved significantly and in the patients of vocal nodule, Shimmer was shown to be improved significantly. In the patients of vocal polyp, Fo was significantly improved. In the patients of vocal cord palsy in litter and NHH were significantly improved. In the patients of dysphonia plica ventricularis, Shimmer and NHR were significantly improved and the patients of functional dysphonia were more improved in Fo, litter and Shimmer. For the aerodynamic analysis, MPT was measured. In particular, it was shown to be improved significantly in the patients of vocal nodule, improved in the vocal polyp, vocal cord palsy, functional dysphonia patients.

• Korean Journal of Head & Neck Oncology
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• v.14 no.1
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• pp.27-34
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• 1998

Objectives, Materials & Methods: To prevent deterioration of postoperative voice due to iatrogenic transection of the recurrent laryngeal nerve during the thyroid surgery, intraoperative medialization of the membranous vocal cord by type I thyroplasty together with direct epineurial neurorraphy was done on 2 cases of benign thyroid lesion. To improve the quality of voice together with complete removal of advanced thyroid carcinoma, intraoperative vocal cord medialization on the lesion side together with total thyroidectomy was done by type I thyroplasty in 2 cases and combined procedure by arytenoid adduction and type I thyroplasty in another 2 cases. Results: The resultant voice of the iatrogenic injury cases was relatively tolerable. The voice of the combined procedure was better than that of type I thyroplasty cases for the intraoperative rehabilitation cases. Not only for the preoperative evaluation of the severity of the nerve lesion but also the prognosis will be expected by use of laryngeal EMG in the cases of thyroid cacer with vocal cord palsy. Conclusion: Intraoperative simultaneous rehabilitation for the vocal cord palsy during thyroid surgery is beneficial for the patients.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.1
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• pp.23-27
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• 2006

Purpose: There are a few case reports on asymmetric vocal cord uptake on FDG-PET in patients with unilateral vocal cord paralysis, which could be a potential pitfall in the interpretation of FDG-PET images. We evaluated the metabolic activity of laryngeal muscles of patients with unilateral vocal cord paralysis in comparison to normal controls during both speech and silence. Methods: Eleven patients with unilateral vocal cord palsy (thyroldectomy=7, lung cancer=1, others=3) and 12 normal controls underwent FDG-PET with usual protocol. They were divided into two groups respectively; one group read books aloud for 20 minutes (phonation group) and the other kept silence (non-phonation groups) after FDG injection. Recent neck CT scan were co-registered with FDG-PET to produce PET-CT fusion images to elaborate small laryngeal muscles. Results: In patients with unilateral vocal cord palsy, contralateral non-paralyzed vocal cord showed hypermetabolism mainly on thyroarytenoid muscle, more intensely with phonation group ($SUV=5.88{\pm}2.65$) than with non-phonation group ($SUV=2.30{\pm}0.39$). Normal control subjects showed hypermetabolism ($3.68{\pm}0.96$) in interarytenoid muscle and symmetric mild hypermetabolism in both lateral cricoarytenoid muscles in only phonation group. Conclusion: FDG-PET with fusion images using CT scan in patients with unilateral vocal cord paralysis showed hypermetabolism of contralateral non-paralyzed thyroarytenoid muscle, suggesting compensatory action during phonation. Phonation durung FDG PET study enhanced FDG uptake on different laryngeal muscles between patients with unilateral vocal cord paralysis and normal subjects.

• Proceedings of the KSLP Conference
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• 2012.03a
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• pp.25-25
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• 2012