• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1993.05a
• /
• pp.75-75
• /
• 1993

A retrospective review of 158 patients who had microlaryngeal surgery for benign vocal cord disease, at the Department of Otolaryngology, Kang-Nam St. Mary Hospital, over 2-year period from Mar. 1991 to Feb. 1993, was completed. Of 158 patients, 16 patients(10.1%, male 8 & female 8, most common in fifth decade) had concomitant vocal sulcus unilaterally (10) or bilaterally (6). Vocal sulcus was accompanied with 7.5% (7/93) of vocal polyp, 15.8% (6/38) of vocal nodule, 11.1% (1/9) of Reinke's edema and 8.3% (1/12) of vocal cyst. Vocal sulcus located above the associated disease in 13(59.1%), below the disease in 7(31.8%) and in the lesion in 2(9.0%). Vocal sulcus was found mainly on the midportion of the membranous vocal cord and the length was less than half of membranous vocal cord in 16(72.7%), more than half in 6(27.3%). In 12 cases (54.5%), vocal sulcus was deep enough to attach to the vocal ligament. We thought it is important to consider the concomitant vocal sulcus during the microlaryngeal surgery for benign vocal cord disease.

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

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.12 no.1
• /
• pp.61-63
• /
• 2001

The mucosal bridge of the vocal fold is an arch of mucosa, formed by some portion of the vocal fold mucosa which is detached in various extension and length. The etiology is uncertain but some is related to vocal sulcus. Because it affects the voice with variable impact, it must be differentiated from functional voice disorder. We report a case of a mucosal bridge of vocal fold with a vocal polyp treated by microlaryngeal surgery and voice therapy.

• Phonetics and Speech Sciences
• /
• v.3 no.4
• /
• pp.103-108
• /
• 2011

The purpose of this study was to investigate the effects of the Bel canto singing technique on voice quality in patients with vocal bowing and sulcus vocalis. Five patients with vocal bowing, and five patients with sulcus vocalis participated in the study. Each subject was assessed acoustically (Jitter, Shimmer, NNE) in the first and last session. Dr. Speech (version 4.0, Tiger-DRS) was used to compare acoustic parameters of pre- and post-treatment. The Bel canto singing technique consisted of breathing exercises, relaxation exercises, and phonation exercises. The results showed that the Bel canto singing technique tended to be effective on improving voice quality in patients with organic voice disorders.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.6 no.1
• /
• pp.9-15
• /
• 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
• /
• v.27 no.1
• /
• pp.25-29
• /
• 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
• /
• v.24 no.2
• /
• pp.112-117
• /
• 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
• /
• v.21 no.1
• /
• pp.17-21
• /
• 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,

• Phonetics and Speech Sciences
• /
• v.4 no.1
• /
• pp.125-131
• /
• 2012

The patients with incomplete glottic closure have an important feature decreasing the maximum phonation time (MPT) because airflow rate or air leakage is greater than people without voice disorders. Also they can appear a problem in the intensity regulation. This study analyzed MPT difference based on the comfortable intensity and louder intensity and the correlation between MPT and respiration volume of unilateral vocal fold palsy (UVFP) and sulcus vocalis (SV) group. The twenty with UVFP, the 21 with SV, the 21 normal subjects measured MPT in /a/ vowel prolongation task with comfortable intensity and louder intensity and compared analysis by measuring FVC, $FEV_1$, $FEV_1/FVC$ to analyze the correlation between MPT and respiration volume. First, a comparison of MPT according to the intensity between groups is that MPT of the normal group was statistically significant long compared to the patient group in comfortable intensity, but MPT between groups was not statistically significant difference in the louder intensity. Second, an analysis of the correlation between MPT and respiration volume is that this was statistically significant correlation between MPT in comfortable intensity and MPT in louder intensity. But this did not show statistically significant correlation between intensity and respiration volume. This study can be supported the preceding study results deduced that shorting MPT of the patient group compared to the normal group was originated in the problem of laryngeal valving mechanism at the level of vocal folds rather than a problem of respiratory function. Also at the phonation by varying the intensity, the result can deduce that in the case of patient group, the length of MPT had been improved by increasing the glottal closure ratio in the louder intensity. These results can support the theoretical basis that should be applied to the clinicians by varying the intensity at the voice evaluation and voice therapy for the patients with the glottis incompetence.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1982.05a
• /
• pp.11.2-12
• /
• 1982

The major advancement in phonosurgery due to recent development of laryngomicrosurgery enabled more accurate diagnosis and treatment of patient with voice disorders. Among large proportion of voice disordered patients, prominent linear furrow running parallel along the free edge of vocal cord extending from the vocal process to anterior commissure can be seen as well as incomplete closure during phonation. These cases were illustrated and coined as sulcus vocalis by Salvi in 1901, since then other similar paper was reported in Europe and Japan, but has not been reported in Korea. The exact etiology and therapeutic methods of sulcus vocalis has not been elaborated. At Department of Otolaryngology of Yonsei University College of Medicine a series of voice analysis were performed among those 35 patients with sulcus vocalis visited to Vocal Dynamics Laboratory from May, 1981 to March, 1982. Following is the result of clinical statistical investgation and therapeutic modality. 1) The incidance of sulcus vocalis among 290 patients with voice disorder visited to Vocal Dynamics Laboratory was approximately 12%(35 cases). 2) Onset of this voice disorder was most frequent among patient under 10 year-old groups; 19 cases (54%) followed by second decade, third decade groups in decreasing frequency respectably. 3) The etiology of sulcus vocalis was mostly unknown. The sequelae after measle (4 cases) and severe upper respiratory infection (3 cases) and congenital deformity (2 cases) were the possible causes of sulcus vocalis. 4) These patients were involved bilaterally in 25 cases (71%), left side only in 8 cases (23%) and right side only in 2 cases (6%). 5) Almost all patients complained hoarseness and 7 patients were suffering from chronic laryngitis. 6) In aerodynamic analysis, Maximal Phonation Time was decreased in 20 cases (57%), Phonation Quotient was increased in 22 cases (63%) and Mean Air Flow Rate was increased in 23 cases (66%). 7) Among them, 33 cases were analyzed with stroboscopy. The findings were as follows; incomplete glottic closure during phonation in 31 cases (93%), regular vocal cord movement in whole cases, asymmetric cord movement in 4 cases (12%), decreased amplitude in 5 cases (21%) and small mucosal wave in 24 cases (73%). 8) Intracordal Teflon injection in 5 cases and Sulcusectomy in 1 cases were performed as therapeutic management, however, the therapeutic results were not effective except one case with Teflon injection.