• Title/Summary/Keyword: Vocal fold

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The Effect of Botulinum Toxin Type A for the Vocal Fold Granuloma (Botulinum Toxin Type A (BOTOX$^{\circledR}$)를 이용한 성대 육아종의 치료효과)

  • 김정홍;김한수;남지인;장정현;김지훈;최홍식
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.14 no.1
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    • pp.40-46
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    • 2003
  • Background and Objectives : The vocal fold granuloma has been associated with vocal abuse, gastroesophageal reflux, endotracheal intubation and habitual throat clearing etc.. Granuloma is benign growth of hypertrophic granulation tissue. It is usually located on the posterior third of vocal fold, in one or both vocal process of the arytenoid cartilage In spite of the voice therapy, steroid therapy, anti-reflex therapy and surgical procedure. The distinct advantage and uniform success rate of each methods have not been generally shown. Authors report that localized injection of botulinum toxin type A (BOTOX$^{\circledR}$) is the promising method both as an initial treatment and as an alternative treatment in patients who do not respond to standard therapy or who are poor surgical candidates. Materials and Method : We carried out a retrospective study of 9 patients with the diagnosis of vocal fold granuloma on the videostroboscopic examination from Jan 2000 to Mar 2003. The botulinum toxin type A was injected into one or both thyroarytenoid muscle or lateral cricoarytenoid muscle under the electromyography. The average dosage ranges from 6U to 8U per injection. Results : Unilateral vocal fold granuloma in 7 patients had been resolved completely within 2-3 months after first injection : 5 patients received th\ulcorner GER medical therapy in addition to the Botulinum toxin injections, 2 patients was resolved completely who had shown recurrence after $CO_2$ laser vaporization. 2 patients who had shown recurrence after $1^st$ injection were also completely resolved within 6 months after further injections. Conclusion : We expect that localized injection of Botulinum toxin type A can provide an alternative treatment for the refractory cases to the traditional forms of therapy and avoid the recurrence in conjunction with proper medical and voice therapy against GER and vocal abuse.

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A Comparative Study of Vocal Fold Vibratory Behaviors Shown in the Phonation of the /i/ Vowel between Persons who Stutter and Persons with Muscle Tension Dysphonia Using High-Speed Digital Imaging (초고속 성대촬영기(High-Speed Digital Imaging)를 이용한 말더듬인과 근 긴장성 발성장애인의 /이/모음 발성 시 성대 진동 양상에 관한 비교 연구)

  • Jung, Hun;Ahn, Jong-Bok;Park, Jin-Hyaung;Choi, Byung-Heun;Kwon, Do-Ha
    • Phonetics and Speech Sciences
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    • v.1 no.4
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    • pp.195-201
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    • 2009
  • The purpose of this study was to use high-speed digital imaging (HSDI) to compare vocal vibratory behaviors of persons who stutter (PWS) and persons with muscle tension dysphonia (PMTD) for uttering the /i/ vowel in a bid to identify the characteristics of vocal fold vibratory behaviors of PWS. This study surveyed seven developmental PWSs and seven PMTDs. The findings of the study indicated the following: first, regarding the two groups' vocal fold vibratory behaviors, of seven PWSs, three were found to be close vocal tract (VC) and four were found to be combination vocal tract (VCB). Of the seven PMTDs, one was found to be VC, and the other six were found to be VCB. These results indicate that a voiceprint which is different from the open vocal tract (VO) found in normal groups in research conducted by Jung, et al. (2008b) appeared in both groups of this study. Even between the two groups, there is a difference in the voiceprint before vocalization. Second, a VKG analysis was conducted to identify the two groups' vocal cord contact quotient. As a result, the PWS group's vocal cord contact quotient changed gradually from an irregular one at the initial vocalization stage to a regular one. The PMTD group continued the tension at the initial vocalization. Putting together all of these results, there is a difference in vocal fold vibratory behaviors between PWSs and PMTDs when they speak. Thus, there was a difference in muscular tension between the two groups.

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Treatment Outcomes and Prognosis of Benign Vocal Fold Lesions (양성 성대 병변의 치료 결과 및 예후인자)

  • Lee, Seung Won
    • 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.

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The Effects of Vertical Laryngeal Movements on the Vocal Folds (후두 수직운동이 성대에 미치는 영향)

  • Hong, Ki-Hwan;Kim, Hyun-Ki
    • Speech Sciences
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    • v.1
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    • pp.261-274
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    • 1997
  • In spite of the presumed importance of the strap muscles on laryngeal valving and speech production, there is little research concerning the physiological role and the functional differences among the strap muscles. Generally, the strap muscles have been shown to cause a decrease in the fundamental frequency(Fo) of phonation during contraction. In this study, an in vivo canine laryngeal model was used to show the effects of strap muscles on the laryngeal function by measuring the Fo, subglottal pressure, vocal intensity, vocal fold length, cricothyroid distance, and vertical laryngeal movement. Results demonstrated that the contraction of sternohyoid and sternothyroid muscles corresponded to a rise in subglottal pressure, shortened cricothyroid distance, lengthened vocal fold, and raised Fo and vocal intensity. The thyrohyoid muscle corresponded to lowered subglottal pressure, widened cricothyroid distance, shortened vocal fold, and lowered Fo and vocal intensity. It was postulated that the mechanism of altering Fa and other variables after stimulation of the strap muscles is due to the effects of laryngotracheal pulling, upward or downward, and laryngotracheal forward bending, by the external forces during strap muscle contraction.

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A Case of Unilateral Vocal Fold Paralysis Caused by Ortner's Syndrome (Ortner's 증후군에 의해 발생한 일측성 성대마비 1예)

  • Park, Sang Hoo;Park, Heon Soo;Bae, Woo Yong;Lee, Dong Kun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.139-141
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    • 2019
  • The causes of vocal cord paralysis include iatrogenic injury during thyroid or cervical surgery, heart and chest surgery, and tumorous lesion such as laryngeal cancer and lung cancer. In addition to these common causes, rarely, cardiovascular disease can also cause vocal fold paralysis. A disease known as Cardiovocal syndrome, or Ortner's syndrome, causes left vocal fold paralysis when the left recurrent laryngeal nerve is compressed by the pulmonary artery and aorta, which is occurred by pulmonary hypertension from heart disease. We report for the first case in Korea the diagnosis of vocal fold paralysis caused by Ortner's syndrome.

Simultaneously Presented Two Histopathologically Different Cysts in Unilateral Vocal Fold : A Case Report (일측 성대에 동시 발생한 다른 두 종류의 성대 낭종 1례)

  • An, Soo-Youn;Ahn, Young-Jin;Sung, Myung-Whun;Kim, Kwang-Hyun;Kwon, Tack-Kyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.19 no.1
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    • pp.58-61
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    • 2008
  • A 66-year-old woman described a 6-month history of hoarseness after upper respiratory infection. She was a house wife and referred from an outside clinic under a diagnosis of vocal fold nodules. Strobovideolaryngoscopy revealed bilateral vocal fold lesions, and decreased mucosal wave of both vocal folds. She was brought to the operating room for microsuspension laryngoscopy. Under general anesthesia, dual intracordal cysts on left vocal fold were completely resected with microflap technique. The lesion on the right vocal fold turned out to be a reactive fibrous mass, which was also resected. Dual intracordal cysts were confirmed histopathologically. The one was an epidermoid cyst lined with squamous epithelium, and the other was a mucus retention cyst lined with cuboidal epithelium. Postoperative voice was acceptable by the patient and the mucosal vibration has much improved after the surgery.

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Dysphonia : Vocal Fold Mucosal Lesions Easily Missed in Laryngoscopy (발성장애: 후두내시경 검사에서 놓치기 쉬운 성대점막질환)

  • Kim, Han-Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.1
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    • pp.17-21
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    • 2010
  • Dysphonia is a medical terminology for voice disorders characterized by hoarseness, harshness, weakness, or even loss of voice ; any impairment in ability to produce voice sounds using the vocal organs, larynx, The causes of dysphonia can be classified into two groups, organic and functional. Functional dysphonia includes spasmodic dysphonia, muscle tension dysphonia, mutational dysphonia and conversion dysphonia, etc, The findings of laryngoscopy in these dysphonia are almost normal. Therefore, physicians should diagnosis these diseases from careful history taking and abundant understandings about the phonation pattern, Organic dysphonia is caused by anatomical problems in the larynx, especially on the vocal fold, Some lesions, however, are not easily found because these lesions are too small, or located on the lower lip of vibrating vocal fold. Laryngopharyngeal reflux induced laryngitis, vascular lesions, sulcus vocalis, vocal atropy including presbylaryngis, and mucosal tears are common lesions easily missed in laryngoscopy, Therefore, a high index of suspicion is necessary to avoid missing vocal fold mucosal lesions, and the strobovideolaryngoscopy is indispensable in making the diagnosis,

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Recent Advances in Examination of Vocal Fold Vibration (성대진동검사의 최신 지견)

  • Lee, Jin-Choon;Bae, Inho
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.32 no.1
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    • pp.1-8
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    • 2021
  • Human vocal cords vibrate as quickly as 100-250 times per second, so it is impossible to observe them with normal endoscopic diagnostic equipment. High-speed videolaryngoscopy (HSV) allows the visualization of non-periodic vibratory motion of vocal fold beyond the limitation of videostroboscopy. New developed post-processing methods that converts HSV to two-dimensional videokymography (2D VKG) using U-medical image-processing software can provide quantitative information on vocal fold mucosa vibration. Multifunctional laryngeal examination system is composed of 3 kinds of examinations such as HSV, 2D scanning digital kymography (2D DKG) and line scanning digital kymography (DKG). Evaluation of entire vocal cord vibratory pattern in each cord is possible using 2D DKG and a faster and more reliable quantitative information can be obtained. As this system is used in clinical and research, it is expected to bring much advances to the diagnosis of voice disorders. In this review, I will introduce the principles and advantages on examination of the vocal fold vibration, which is in the spotlight recently, and proceed with the literature review.

Development and Clinical Application of Real-Time Light-Guided Vocal Fold Injection (실시간 광유도 성대주입술의 개발과 임상적 적용)

  • Huh, Gene;Cha, Wonjae
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.33 no.1
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    • pp.1-6
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    • 2022
  • Vocal fold injection (VFI) is widely accepted as a first line treatment in treating unilateral vocal fold paralysis and other vocal fold diseases. Although VFI is advantageous for its minimal invasiveness and efficiency, the invisibility of the needle tip remains an essential handicap in precise localization. Real-time light-guided vocal fold injection (RL-VFI) is a novel technique that was developed under the concept of performing simultaneous injection with precise placement of the needle tip under light guidance. RL-VFI has confirmed its possibility of technical implementation and the feasibility in injecting the needle from various directions through ex vivo animal studies. Further in vivo animal study has approved the safety and feasibility of the procedure when various transcutaneous approaches were applied. Currently, RL-VFI device is authorized for clinical use by the Ministry of Food and Drug Safety in South Korea and is clinically applied to patients with safe and favorable outcome. Several clinical studies are currently under process to approve the safety and the efficiency of RL-VFI. RL-VFI is expected to improve the complication rate and the functional outcome of voice. Furthermore, it will support laryngologists in overcoming the steep learning curve by its intuitive guidance.

A Case of Amyotrophic Lateral Sclerosis with Unilateral Vocal Fold Palsy and Velopharyngeal Insufficiency (일측성 성대마비와 구개인두부전을 초기 증상으로 내원한 Amyotrophic Lateral Sclerosis 1 예)

  • 박경호;김동현;조승호;김형태
    • 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.

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