• Korean Journal of Bronchoesophagology
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• v.17 no.2
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• pp.112-115
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• 2011

Several reports have investigated airway obstruction caused by redundancy of arytenoid mucosa. Flexible laryngoscope examination revealed prolapse of the mucosa overlying the arytenoid. Usually, pharyngeal or laryngeal microscopic procedures can successfully treat the redundancy of arytenoid mucosa. We experienced two cases of airway obstruction caused by redundancy of artenoid mucosa and report it with review of literatures.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.90-95
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• 2014

Background and Objectives : Arytenoid adduction procedure is one of the main surgical options addressed for the correction of glottal incompetence in patients with unilateral vocal cord paralysis. Traditionally, a midline approach is used for identifying and suturing around the muscular process, which often needs over-traction of the thyroid cartilage and results in patient's discomfort as well as surgeon's distress. The authors investigated the advantage of a modified procedure, lateral approach, in which the arytenoid cartilage is exposed through the space between strap muscles and sternocleidomastoid muscle. Materials and Methods : Retrospective chart review was performed for 66 patients who received arytenoid adduction surgery at Samsung Medical Center, between the year 1997 and 2014. Operation time, types of anesthesia, voice outcomes and complications were compared between the midline (n=22) and the lateral (n=44) approach group. Results : Operation time was shorter in the lateral approach group ($125{\pm}24min$) than in the midline group ($144{\pm}24min$). Arytenoid adduction was proceeded under local anesthesia in 66% (n=29/44) and 14% (n=3/22) of patients with lateral and midline approach group, respectively. Voice outcomes and complication rates were comparable between the two groups. Injection laryngoplasty in conjunction with arytenoid adduction resulted in more favorable voice outcomes. Conclusion : A lateral approach for the arytenoid adduction procedure showed comparable voice outcomes and similar complication rates with those of a midline approach. However, lateral approach provided less discomfort to the patients and less distress to a surgeon, and therefore, shorter operation time was needed and local anesthesia could be more frequently applied for this modified procedure.

• Journal of Veterinary Clinics
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• v.39 no.6
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• pp.400-404
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• 2022

A 3-year-old Thoroughbred gelding presented with left laryngeal hemiplegia with a history of laryngoplasty (tie-back surgery) failure. Postoperative endoscopy revealed no abduction or no inflammatory changes in the left arytenoid cartilage. The owner opted for the horse to undergo partial arytenoidectomy due to failed laryngoplasty. A tracheostomy tube was intubated through a mid-cervical tracheotomy to secure the airway under general anesthesia, and; laryngotomy was performed to access the arytenoid cartilage in dorsal recumbency. A partial arytenoidectomy was performed with endoscopic assistance through the left nostril, and the left arytenoid cartilage was removed, excluding the muscular process. Antibiotic and anti-inflammatory agents were administered postoperatively, and the incision site was cleaned using normal saline and antibiotic ointment twice daily. On the 12th postoperative day, endoscopy revealed redundant corniculate process mucosa at the surgical site, which was removed using rongeur forceps directly through the previous laryngotomy incision. The horse showed no significant complications during the hospitalization. Two months after surgery, the surgical site reportedly recovered with no evidence of granulation tissue. The horse returned to training and racing 3 and 7 months postoperatively, respectively. This is the first case report of a partial arytenoidectomy in a horse in South Korea. In this case, the horse returned to training after partial arytenoidectomy without significant complications, indicating that partial arytenoidectomy could be beneficial for failed laryngoplasty.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.8.2-8
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• 1982

Hoarseness is the change of voice quality which represents the abnormal function of phonation and is the main symtom of the laryngeal diseases. The etiology of hoarseness are known more than 50 causes, among them, viral upper respiratory infection is the main cause of hoarseness and the laryngeal nodule and polyp, laryngeal paralysis, laryngeal cancer, laryngeal papilloma and the laryngeal tuberculosis are the other causes of hoarseness in that order. Recently, the authors experienced 4 cases of uncommon etiology of hoarseness, so we present the cases with the brief review of literatures. Case 1. 29 years old male Admitted in Dept. of neurosurgery due to Traffic Accident. He had a trauma on the anterior neck. Hoarseness was developed on 1 month after the accident. Laryngoscopic finding; Paramedian paralysis of left vocal cord. Displacement of left arytenoid cartilage. Case 2. 53 years old male Admitted in Dept. of General Surgery due to Clonorchis Sinensis, under the general endotracheal anesthesia, Choledochostomy was performed. Laryngoscopic finding; Median paralysis of left vocal cord. Case 3. 56 years old male Admitted in Dept. of Internal Medicine due to Aortic Aneurysm. Hoarseness was developed on 3 months prior to admission. Laryngoscopic finding; Intermediated position paralysis of left vocal cord. Displacement of left arytenoid cartilage. Case 4. 74 years old male Admitted in Dept. of Internal Medicine due to Bronchogenic carcinoma. Hoarseness was developed on 3 years prior to admission. Laryngoscopic finding; Paramedian paralysis of right vocal cord.

• Korean Journal of Bronchoesophagology
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• v.11 no.1
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• pp.28-31
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• 2005

Granular cell tumors are relatively uncommon benign laryngeal lesions thought to originate form Schwann cells. The granular cell tumor occurs everywhere in the body, especially in the head and neck. The larynx is relatively an uncommon location, accounting for approximately 3 to $10\%$ of all reported cases. Typically the most common presenting symptom is hoarseness, with some patients also presenting stridor, hemoptysis, dysphagia, and otlagia. But the tumor may be asymptomatic and discovered only incidentally during a routine examination. The diagnosis of granular cell honor can be confirmed by histopathologically and immunocytochemical staining fer S-100 antigen. Treatment of a granular cell tumor consists of a wide local excision by the endoscopic, transoral or laryngofissure methods. Recently, CO2 laser has been used to remove granular cell tumor with clear resection margin. This article describes one such case in a 62-year-old man, followed by a brief review of the literature on this subject.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.1
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• pp.7-10
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• 2007

Unilateral vocal fold paralysis resulting in glottal incompetence can cause significant morbidity attributable to impaired speech, swallowing, and ability to protect the airway. The treatment of unilateral vocal cord paralysis has a long history, marked by technical innovations and improvements. These methods typically use endoscopic injection or implants to augment the volume of the affected vocal fold. The first known treatment, reported by Brunnings in 1911, was paraffin injection. The first thyroplasty medializing the paralysed vocal cord was performed by Payr in 1915 ; here, a cartilage door-flap was created from the thyroid ala to obtain better voice quality. In the 1970s, Isshiki systematized and developed the use of the external medialization by Payr. Later he modified his original technique, and achieved safer and better results. Many other methods were introduced for external medialization during the 1980s and 1990s. There has been couple of materials using for medialization laryngoplasty: silicone bloc, cartilage, goretex (polytetrafluoroethylene), titanium, etc. Among them, silicone bloc is the most popularly used material. Type I thyroplasty in combination with arytenoid adduction is a proven technique for medialization of the paralysed vocal fold. In this paper, personal experience for using silicone bloc type I thyroplasty : decision making and practical points, long-term results and complication of the procedure will be discussed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.1
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• pp.36-38
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• 2014

The patient suffered cardiac arrest 8 months before presentation. She has been suffering hoarseness and exertional dyspnea and nocturnal stridor. Upon flexible laryngoscopy, her vocal cords showed no motion and fixed in paramedian position. There was no causal finding on neck CT. EMG showed some muscular activity. Under the suspicion of crico arytenoid fixation, we performed suspension laryngoscopy, and found the arytenoid cartilage was fixed with short and stout scar, which was removed with scissors. Just after surgery she regained her voice and respiration.

• 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.

• Proceedings of the KSLP Conference
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• 2003.11a
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• pp.182-182
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• 2003

Objectives : The methods to treat glottic incompetence include thyroplasty type I, arytenoid abduction, and intracordal injection using various materials. The intracordal injection is easy and simple and does not require skin incision. In general, the grafted cartilage shows a high survival rate, a low absorption rate and small voluminous change. The authors performed injection of minced autologous auricular cartilage and fat using a Bruning injector in unilateral vocal cord palsy We evaluate the effect and safety of autologous auricular cartilage intracordal injection. Study Design : Retrospective study. Methods : Auricular cartilage was obtained by incising tragus vertically and it was minced with a scalpel and #15 blade. About 2g of abdominal fat was obtained by small periumbrical incision and cut into small pieces. The minced cartilage was put into a 1$m\ell$ injector and then the injector was filled with fat. The operation was conducted under laryngeal microscope. Minced cartilage was injected into the vocalis muscle at the junction of the middle and posterior third of the vocal fold. In three cases, we performed autologous cartilage intracordal injection. Results : We observed no postoperative complications, such as dyspnea, granulation, inflammation, in any of the cases. The voice was improved compared with the voice prior to operation in all cases. Conclusion : Although the cases are still limited and the observation period is short, we suggest that the autologous cartilage using the auricular cartilage is the ideal and new effective augmentative material in vocal cord palsy.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.90-90
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• 1993

When illustrating the therapeutical plan of laryngeal cancer, there are difficulties in obtaining the three dimensional volume of tumor, submucosal extension of tumor, and particularly whether or not invasion on laryngeal cartilage has occurred. In particular clinical significance is the invasion to the laryngeal framework, which correlates with poor prognosis due to high frequency of local recurrence and cervical metastasis. Therefore the purposes of histopathological evaluation according to serial section study after laryngectomy are firstly, apprehension of the spread of laryngeal cancer and the pattern of invasion to laryngeal cartilage and secondly, obtaining an aid to establish direction of management to make higher the validity of preoperative clinical diagnosis. The following results were obtained : 1. The pattern of tumor invasion in cartilage 1) The tumor invades ossified cartilage chiefly and invades nonossified cartilage in extensive lesion only. 2) The tumor spread through intramarrow space at invaded ossified cartilage with intact perichondrium. 3) The perichondrium is strong barrier. 2. The incidence of cartilage invasion in order of frequency is as follow thyroid, arytenoid, cricoid, epiglottic cartilage. 3. The transglottic cancer has higher incidence(811.8%)of cartilage invasion. 4. The sensitivity, specificity, and accuracy rate of preoperative CT scan was 100%, 62.5%, 82.3% respectively.