• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.1
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• pp.48-51
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• 2012

Background and Objectives : Vocal fold cyst is generally treated by surgical resection, it has a difference with vocal fold polyp, treated by conservative management first. Decrease in mucosal waves is known as main diagnostic criteria of vocal fold cyst. Sometimes there is a difficulty for diffrential diagnosis between cyst and polyp only by endoscopic examination. The purpose of the study is to identify the objective features of vocal cyst and polyp on the basis of voice analysis for the proper differential diagnosis, especially at high pitched phonation. Materials and Method : The voice analysis was done in 15 focal fold cyst patients and 42 vocal fold polyp. Parameters of perceptual assessment, acoustic and aerodynamic measure, and voice range profile were compared between two groups. Results : Vocal fold cyst patients showed significantly reduced MPT by acoustic and aerodynamic analysis, narrowed frequency-range and low maximun frequency by voice range profile analysis compared with vocal fold polyp patient. Maximun frequency 381 Hz is established for cut off value, differential diagnosis between cyst and polyp (ROC analysis, sensitivity 60%, specificity 68%). Conclusion : Voice analysis is helpful for differential diagnosis between vocal fold cyst and polyp, especially there is a difficulty for distinguish cyst from polyp at clinical situation by endoscopic examination. The result of decreased maximum frequncy at vocal fold cyst supports incomplete high-pitched phonation and falsetto regester at vocal fold cyst patients due to decreased mucosal wave, compared with vocal fold polyp patients.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.122-128
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• 2007

This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.1
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• pp.51-54
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• 2013

False vocal fold hypertrophy caused by diverse pathologic lesion, such as laryngeal amyloidosis, laryngeal lipidosis, laryngocele, saccular cyst and sulcus vocalis. False vocal fold hypertrophy, however, is also caused laryngeal structure deformity, irrespective of pathologic lesions. In this article, we report some cases of false vocal fold hypertrophy caused by inward bowing of thyroid cartilage. At the clinic of the department of otorhinolaryngology in Gangnam Severance Hospital, with 3 male complained of hoarseness as subjects, and comfirmed of false vocal fold hypertrophy using the stroboscopy and larynx CT we checked vocal fold and laryngeal structure. Three patients with apparent hypertrophy of false vocal fold were investigated with computerized tomography (CT). In all patients, marked concavity of thyroid cartilage was revealed in CT scan at the level of the false vocal fold, and this deformity of the thyroid cartilage seemed to cause a protrusion of false vocal fold which taken as hypertrophy in stroboscopy. Careful palpation of the larynx and a CT scan taken at the level of the false vocal fold should be useful in determining whether hypertrophy of the false vocal fold is pathologic. For the next articles, It is necessary to discuss for the cause, diagnosis, treatment and prevention of inward bowing of thyroid cartilage.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.37-40
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• 2018

Background and Objectives : This study aimed to evaluate patients' subjective and objective outcomes after laryngeal microsurgery for benign vocal fold (VF) lesions, and to identify usefulness of surgical treatment. Materials and Methods : The authors reviewed the 102 patients medical records, retrospectively who received laryngeal microsurgery for benign VF lesions from January 2013 to August 2017. Subjective voice were measured using the Voice Handicap Index (VHI). Objective voice were recorded with Multi-Dimensional Voice Program (MDVP) just before surgery, and after at least 3 months of surgery. Results : Benign VF lesions were categorized as VF nodule (n=34, 33%), VF Polyp (n=47, 26%), Intracordal cyst (n=15, 15%), Reinke's edema (n=6, 6%), and VF Papilloma (n=2, 2%). Post-operative voice assessment at VHI scores showed statistically significant reductions in all of functional, physical and emotional parts (p<0.001). MDVP were showed significant improvement of Jitter (P=0.001), Shimmer (p<0.001) and Noise to Harmonic Ratio (NHR) (p=0.001). Conclusion : Laryngeal microsurgery for benign vocal fold lesions is effective treatment with statistically significant improvement at subjective and objective vocal quality assessment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.1
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• pp.60-62
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• 2011

Primary laryngeal aspergillosis is rare, It is most often found in immunocompromised patient, such as leukemia, malignant disease, diabetes or immunosuppressive drugs. These days the occurrences of laryngeal aspergillosis in immunocompetent patients are increasing. The cause of laryngeal aspergillosis in immunocompetent patients is not clear, but a few factors are considered such as iatrogenic factors, vocal abuse, vocal fold cyst and occupational factors. The histopathologic characteristics are somewhat different between that of immunocompromised patients and immunocompetent patients. We report a case of primary vocal cord aspergillosis in immunocompetent patient who had treated with only surgery and brief review of the pertinent literature.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.13 no.2
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• pp.173-179
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• 2002

Background and Objectives : Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They nay occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. Recently, with the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Method : In the present study, 121 cases of the intracordal cyst were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 121 cases in the 2595 patients who underwent laryngeal micorosurgery(4.7%). Ductal cyst were 88 cases and epidermoid cyst were 33 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the indirect laryngoscopic examination, the ductal cysts are more frequently misdiagnosed as other diseases of the vocal cord such as vocal polyps or nodules. The degree of postoperative voice satisfaction is similar to that of vocal polyps. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without upture of the cystic wall or injury of the lamina propria.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.47-51
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• 2009

Background and Objectives: Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They may occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. With the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Methods: In the present study, 212 cases of the intracordal cysts were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 212 cases in the 4,20 I patients who underwent laryngeal microsurgery (5.04%). Ductal cysts were 156 cases and epidermoid cysts were 56 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the preoperative laryngoscopic examination, the intracordal cysts were mostly misdiagnosed as other disease of the vocal cord such as vocal polyps or nodules. And main cause of intracordal cysts was thought of vocal abuse. From view of the surgical approach, Ductal cysts was difficult to remove completely than epidermoid cyst without cystic wall rupture. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without rupture of the cystic wall or injury of the lamina propria. And marsupialization is meaningful to ductal cyst that cannot be enucleated completely.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.1
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• pp.53-55
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• 2006

Background and Objectives: The purposes of this study are to find out clinical causes, clinical characteristics and treatment outcomes in relation to anatomical location of laryngeal cyst. Subjects and Method: A retrospective study of medical records was carried out for 170 patients with cysts on vocal cord, epiglottis, vallecula, arytenoid and aryepiglottic fold. Results: There were 83 cases of epiglottic cysts, 41 cases of vallecular cysts, 35 cases of intracordal cysts, 3 cases of arytenoid cysts and 2 cases of aryepiglottic cysts. Laryngeal cysts were more common in men than in women, and the ratio between men and women was 2:1. The age of patients ranged from 7 to 90 years, with their average age being 52 years. The most common symptom was voice change at intracordal cysts and globus sensation at vallecular and epiglottic cysts. The most common cause of intracordal cysts were voice abuse. But other location of laryngeal cysts doesn't have common causes. The average size of cysts was 0.3cm at vocal cord, 1.43cm at epiglottis, 1.4cm at vallecula, 0.9cm at arytenoid and 1cm at aryepiglottis. Recurrence was observed in 7 cases from 1 months to 18 months following the operation. Size of all recurred cysts was over the average. Conclusion: Physicians should be aware of changes in clinical patterns of laryngeal cysts according to location and have long follow-up period at large cysts after operation.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.1
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• pp.52-55
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• 2012

Background and Objectives : Based on histological findings, intracordal cysts are divided in two subtypes : retention cysts and epidermoid cysts. They are typically located in the superficial layer of the lamina propria and appeared as opaque ovoid buldging masses underlying the epithelium. They are characterized by unilateral diminished mucosal wave on stroboscopy. In this article, we report some cases of patients with an oval shaped-yellowish flat cyst. Materials and Method : At the clinic of the department of otorhinolaryngology in Gangnam Severance Hospital, with 3 female complained of hoarseness as subjects, using the stroboscopy we checked preoperative and postoperative vocal cord and operative findings. Surgery was performed under general anesthesia by the senior authors. All patients noted subjectively that their performing voice was improved. Results : During surgery, an oval shaped-yellowish flat cystic lesion was distinguished from normal epithelium. On palpation of this area with microforceps and cottons, the yellowish discharge was noted to move out from the opening of the cyst. In one case, the cyst was ruptured but remove the capsule completely. In other cases, sulcus was noted at the oppsite site. Conclusion : Because of the opening, the cyst was not easy to dissect and remove completely. After the debris was move out, fibrosis around the opening and invaginated epithelium extending into the deeper layers to the fold. The cyst was must removed carefully and completely for improvement of voice quality before evolving into a sulcus vocalis.