• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.1
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• pp.35-38
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• 2020

Spasmodic dysphonia is a disease presumed to be a form of focal laryngeal dystonia. The widely used first-line treatment is botulinum toxin injection to the thyroarytenoid muscles. In spite of the effectiveness and safety of this method, it has a temporary effect that lasts only several months, resulting the patients' symptom fluctuating, called 'Botox rollercoaster.' Some surgical techniques had tried, but they had shown several limitations including high rate of recurrence. We tried thyroarytenoid myectomy with selective recurrent laryngeal nerve section in a patient with intractable spasmodic dysphonia. This procedure is an alternative treatment of spasmodic dysphonia to prevent recurrence and improve symptoms. During five years of follow-up, she has shown steady quality voice without any complication. To the best of our knowledgement, this is the longest follow-up case of this operation in South Korea.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.1
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• pp.15-20
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• 2019

Background and Objectives : The goal of this study is to present a strategy for improving the self-regulation (SR) ability and facilitating the change of vocal behavior by applying voice therapy using the SR concept to the patients with vocal cord nodule and muscle tension dysphonia. Materials and Method : The subjects were 80 patients and 80 patients who were diagnosed with muscle tension dysphonia and vocal nodules. As a control group, the results were compared among patients with the same dysphonia without using SR strategies. The concept of SR before voice therapy was explained to the patients, and the treatment was divided into three stages according to the goal of voice therapy. The treatment stages consist of 1) skill acquisition, 2) habit formation, and 3) habit changes. voice therapy was performed by applying SR strategies such as goal implementation intentions and a less routine behavior. Patient's dropout rates were measured to compare the adherence of voice therapy. Results : Significant improvement was seen in all groups receiving voice therapy. However, in the group using the SR strategy, the voice analysis results showed a relatively low dropout rate of voice therapy. In the generalization confirmation stage, patients who applied SR concept showed better results. SR strategy did no longer be necessary to maintain newly adopted vocal behavior. Conclusion : The results of this study show that SR is one of the cognitive factors that can have a significant impact on the outcome of voice therapy, and also has a positive impact on the acquisition and generalization of new skills. A better understanding of SR and the development of therapeutic strategies using it will play an important role in solving voice problems in clinical settings.

• Proceedings of the KSLP Conference
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• 1996.11a
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• pp.86-86
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• 1996

연축성 발성장애(spasmodic dysphonia)는 아직까지 그 원인을 정확히 밝혀내지 못하고 있는 만성적인 발성장애로 과거에는 경직성 발성장애(spastic dysphonia)로 불리던 질환이다. 연축성 발성장애는 두 종류 즉, 내전형(adductor)과 외전형(abductor)으로 나누어지며 이중 내전형이 대부분이다. 외전형 연축성 발성장애는 발성도중에 성대가 갑자기 불수의적으로 외전되면서 음성이 중단되므로 원활히 대화하기가 힘든 질환이다. 이러한 질환은 국소적 근긴장이상(fecal dystonia)의 일종이다. 현재까지 연축성 발성장애의 치료법으로 사용되고 있는 것으로는 언어치료, botulium 독소주입술, 편측반회후두신경절 단술, 반회후두신경분쇄술, 상후두신경절단술, 갑상연골성형술, implantable stimulator 등이 있다. 연축성 발성장애 환자에 $Botox^{circledR}$ 주입에 관한 보고는 주로 내전형에 대해서만 보고되고 있으며 외전형에 대하여 보고된 예는 매우 적다. (중략)

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.1
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• pp.22-26
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• 2010

Neuromuscular Disorders Affecting the Larynx are steadily important topics at laryngology. Physiology of larynx is controlled by the frame structure and neuromuscular dynamics to acting on the specialized soft tissue, Therefore, for a proper understanding of the larynx, it is needed the voice and swallowing, a series of prayers on the regulation of neurologic function and the correlation between systemic neuromuscular disease and laryngeal symptoms and clinical knowledge, We described that clinical findings and treatments of the 3 neurological diseases causing dysphonia well (Parkinson's disease, laryngeal tremor, spasmodic dysphonia) and vocal impairments for stoke patients.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.1
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• pp.13-16
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• 2010

Diagnosis of a patient with dysphonia begins with a thorough history and physical examination. Larynx can be visualized either indirectly or directly with a rigid or flexible laryngoscope. One notable limitation of simple indirect laryngoscopy is that the examination dose not yields a recordable and reproducible image of the larynx and vocal tract. And unaided human eye is unable to visualize the vibratory patterns of the true vocal cord during phonantion. When available, stroboscopy provides useful information regarding vocal told closure, vibration, and mucosal wave which is useful to decide between microsurgery, vocal reeducation or a combined treatment Even there are some limitations, recognition of the advantages and disadvantages of stroboscopy allows for optimal appreciation and stroboscopy remains an essential diagnostic tool in the assessment of dysphonia.

• Journal of Trauma and Injury
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• v.35 no.2
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• pp.115-117
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• 2022

"Whiplash"-type injuries are commonly encountered and often cause neck pain, neck stiffness, and headaches. However, these injuries can have rare and poorly recognized complications, such as the development of a prevertebral hematoma leading to acute respiratory failure in the emergency department, followed by severe, life-threatening dysphagia and recurrent aspirations. In the patient described herein, a whiplash injury was accompanied by vocal cord paralysis and dysphonia (vagus nerve), dysgeusia (glossopharyngeal nerve, vagus nerve), and upper esophageal spasm (cricopharyngeal muscle, vagus nerve). It is unlikely that this was a complication of cervical fusion surgery. Instead, a combined stretch-induced lower cranial nerve injury, possibly on the exit of these nerves through the jugular foramen, seems to be a likely, but underappreciated mechanism occurring in rare instances of whiplash injuries.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.137-142
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• 2011

Background and Objectives : The aim of this study is to introduce Korea version of pediatric VHI and to compare pVHI-K scores between children with dysphonia and children without voice problems before pVHI-K is developed as a preliminary study. Additionally, the relationship between pVHI and acoustic measures were investigated. Materials and Methods : pVHI-K scores in normal group were obtained from 15 parents who have children with no present or past history of a voice disorder, hearing loss, or related disability that can affect the their voice or speech. Dysphonia group consisted of 15 parents who have children with bilateral vocal fold nodule's at Department of Otolaryngology, the Seoul National University Hospital (SNUH). pVHI-K and acoustic parameters were measured in two group. Results : The mean pVHI scores (total, functional, physical, emotional) in normal group were 2.33 (T), 0.80 (F) 1.33 (P) and 0.27 (E), respectively whereas those of pVHI in children group with dysphonia were 23.13 (T), 11.07 (F), 5.73 (P) and 6.13 (E), respectively and significant differences were revealed in total pVHI score as well as in all of the sub-pVHI scores. Moreover, significant correlation between pVHI-K parameters (T, F, P) and acoustic measures [Shimmer(%)] were shown in children in dysphonia group. Conclusion : Reported by parents can be useful as a supplementary clinical tool for diagnosing and measuring treatment effectiveness in young children with dysphonia.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.2
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• pp.100-105
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• 2017

Background and Objectives : Adductor type spasmodic dysphonia (ADSD) is neurogenic disorder and focal laryngeal dystonia, while muscle tension dysphonia (MTD) is caused by functional voice disorder. Both ADSD and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. The aim of this study was to determine the utility of spectrogram analysis in the differentiation of ADSD from MTD. Materials and Methods : From 2015 through 2017, 17 patients of ADSD and 20 of MTD, underwent acoustic recording and phonatory function studies, were enrolled. Jitter (frequency perturbation), Shimmer (amplitude perturbation) were obtained using MDVP (Multi-dimensional Voice Program) and GRBAS scale was used for perceptual evaluation. The two speech therapist evaluated a wide band (11,250 Hz) spectrogram by blind test using 4 scales (0-3 point) for four spectral findings, abrupt voice breaks, irregular wide spaced vertical striations, well defined formants and high frequency spectral noise. Results : Jitter, Shimmer and GRBAS were not found different between two groups with no significant correlation (p>0.05). Abrupt voice breaks and irregular wide spaced vertical striations of ADSD were significantly higher than those of MTD with strong correlation (p<0.01). High frequency spectral noise of MTD were higher than those of ADSD with strong correlation (p<0.01). Well defined formants were not found different between two groups. Conclusion : The wide band spectrograms provided visual perceptual information can differentiate ADSD from MTD. Spectrogram analysis is a useful diagnostic tool for differentiating ADSD from MTD where perceptual analysis and clinical evaluation alone are insufficient.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.2
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• pp.129-132
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• 2003

Chlorine gas is highly irritating gas that, when inhaled, can damage larger airways as well as distal lung structure. It occurs usually result in mild ocular, oropharyngeal, or respiratory symptom and recovery may proceed slow for several weeks. We reported four cases of dysphonia due to acute chlorine inhalation during a swimming pool accident were treated by voice therapy and medication.

• The Journal of Korean Medicine
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• v.16 no.1 s.29
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• pp.251-270
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• 1995

In the Literatual Study on the Dysphonia, the results were as follows. 1. The causes of dysphonia are exogenous pathogenic factors,(specially cold evil)internal damage and meridian in The Yellow Emperor's Canon of Interal Medicine, since then endogenous pathogenic factors are lung-asthenia and deficiency of lung-yin etc. The main causes are disease caused by exogenous evils, general body weakness, emotional stimulation and excess of high voice rescently. 2. The pathogenesis of dysphonia originated from two factors; The first internal damages are consumption of body fluid with the formation of dryness evil resulting from the insufficienty of lung-yin and lung-collaterals damaged by heat-evil caused by deficiency of lung and kidney-yin. The second disease caused by exogenous evils is sluggishness of lung-energy caused by exogenous pathogenic factors. 3. The main relative organ are heart, lung and kidney etc. 4. The prescriptions of wind-cold symptoms are Samyoutang(三拗湯) and Hangsosan(杏蘇散), in the prescriptions of phlegm-heat symptom is Chenginyongphetang(淸咽寧肺湯), in the prescriptions of depressive syndrome due to disorder of vital energy are Sogangkitang(小降氣湯) and Shihochenggantang(柴胡淸肝湯加減), in the prescriptions of consumption of body fluid with the formation of dryness evil resulting from the insufficiency of lung-yin symptoms are Sanghangtang(桑杏湯) and Chenginguphetang(淸咽救肺湯, in the prescriptions of deficiency of lung and kidney-yin are Baekhabgokumtang(百合固金湯) and Maekmigiwhangtang(麥味地黃湯). 5. The treatment of acupunctures are used by LI-4(合谷), H-7(湧泉), Liv-3(太衝), K-3(太谿), Sp-6(三陰交), H-5(通里), GV-15(아門), CV-23(廉泉), S-40(農隆), K-6(照海), L-7(列缺), S-36(足三里) etc.