• 대한기관식도과학회지
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• 제7권2호
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• pp.161-167
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• 2001

Background and Objectives： Total laryngectomy is often required for advanced cases. But this operation induced the many inconvenience of basic daily life. Early diagnosis of laryngeal cancer is very important to prevent from this disastrous condition. In this point of view, mass screening test for early detection of laryngeal cancer is necessary. Screening test using voice has many advantages such as simple, less interventional. Voice collection by Automatic Response System(ARS) is comfortable and easy to got acoustic sample. Thus author tried to got the acoustic parameters which can differentiate normal, benign. and malignant laryngeal diseases and also checked the availability of parameters on neural network system. Materials and Methods: Author has evaluated the voice from 17 laryngeal cancer patients and 45 benign laryngeal disease patients who visited at Department of Otolaryngology, Pusan National University Hospital from May 1998 to April 2001, and 15 normal control. Author chose the sir Parameters (Jitt. vFo, Shim, vAm, NHR, SPI) that was thought to be related with voice collected by ARS among thirty-three parameters analysed by a Multi-Dimensional Voice Program (MDVP). Two-step neural network was used for the availability of six parameters. Results: The detection rate of normal voice by ARS voice analysis is 78.5% and detection rate of abnormal voice was 97.1 o/o. Among abnormal voice, the detection rate of benign laryngeal diseases and laryngeal cancers were 82.4 o/o, 70.6% respectively. Conclusion: Author concluded that six parameters and Matlab based neural network software may be effective in development of acoustic screening system for laryngeal cancer and further study should be necessary for development of new acoustic parameters.

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1979년도 제13차 학술대회 연제순서 및 초록
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• pp.9.5-9
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• 1979

후두에 발생한 신경성종양은 극히 드물 질환이며 신경초종 혹은 신경섬유종이 나타난다. 현재까지 약 100례 이하의 신경성종양의 보고가 있으며 이들중 신경섬유종양과 동반된 예는 20례에 불과하다. 주 증상으로는 호흡곤란, 발성장애와 언어장애등이 있으며 어느 연령에나 발생할 수 있다. 저자들은 2례의 후두의 신경섬유종을 보고하고자 한다. 증례 1은 선천성후두신경섬유종으로 2개월된 남아는 생후즉시로 부터 심한 호흡곤란과 발성장애가 있었으며, 증례 2는 28세의 여자에서 다발성신경섬유종증(von Recklinghausen's disease)에 동반하여 후두에 신경섬유종이 발생한 예이다. 본 논문에서 자자들은 증례보고와 함께 문헌고찰을 하고자 한다.

• 대한후두음성언어의학회지
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• 제19권1호
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• pp.43-46
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• 2008

Background and Objectives : Clinical suspicion and appropriate diagnostic procedures are essential for the timely management of extrapulmonary type of mycobacterial disease. In the hope of suggesting a suitable guideline for the early diagnosis of laryngeal tuberculosis, the authors reviewed their clinical pathways and the characteristics of patients with laryngeal tuberculosis who were managed in the recent 10 years at a single tertiary referral hospital, Samsung Medical Center. Subjects and Method : Retrospective chart review was performed for the 25 adult patients with laryngeal tuberculosis. Among 25 cases, 12 were pathologically confirmed by laryngeal biopsy and the other 13 were clinically diagnosed by cumulative clinical information; definite laryngitis on laryngoscopy, positive AFB (acid fast bacillus) smear/culture or active pulmonary tuberculosis on chest X-ray, and substantial response to anti-tuberculosis medication. Results : Chest X-ray revealed active pulmonary tuberculosis in 72% of patients (N=18/25). Sputum AFB smear/culture was positive in 95% of all tested patients (N=21/22) and in 100% of the tested patients who have stable or no evidence of pulmonary tuberculosis (N=5/5). All patients except one who had coexisting laryngeal malignancy showed considerable improvement in their subjective symptoms and laryngeal findings within the first 2 months of anti-tuberculosis medications and they achieved complete response on subsequent sputum studies, chest X-ray and laryngeal findings after $7.0{\pm}2.3$ months of the medications. Conclusion : We suggest that chest X-ray and sputum AFB smear/culture to be the first step of work-up for the patients having laryngeal tuberculosis in suspicion since laryngeal tuberculosis is largely associated with active pulmonary tuberculosis and/or sputum AFB study offers high yield even in case of primary laryngeal tuberculosis. However laryngeal biopsy must be considered in case showing unsatisfactory response to the anti-tuberculosis medication for more than 2 months.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.61-65
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• 2020

Background and Objectives The overall incidence of laryngeal tuberculosis (LT) has generally decreased over the recent years, yet there is still a discrete population of patients newly diagnosed with the disease. This study is aimed to examine the patients with LT over the recent 10 years and to investigate the changes in clinical pattern with respect to the past period. Materials and Method A retrospective review has been performed on 20 patients who have been initially diagnosed with LT between 2005 and 2015. Results The age of the patients ranged from 25 years to 95 years with an average age of 45.6 years. Seventeen patients (85%) showed hoarseness, which was the most common clinical symptom. Most affected lesion was the true vocal cord. Laryngoscopic examination showed various clinical manifestations: polypoid 30%, granulomatous 25%, nonspecific 25%, ulcerative 20%. A variety of methods were used for diagnostic confirmation of LT [acid-fast bacilli (AFB) smear 45%, AFB culture 40%, polymerase chain reaction 30%, surgical pathology 45%]. Coexisting pulmonary tuberculosis (PT) was detected in 10 patients (50%). Relative to the patients with inactive PT or normal lung status, those with active PT showed higher incidence of laryngeal lesions located in areas other than true vocal cord (p=0.050). Conclusion Based on the analytic results from this study, laryngologists should recognize the changes in the recent clinical patterns of LT and always be ready for clinical suspicion of this disease on such atypical laryngeal findings which can often mimic laryngeal malignancies to provide the pertinent treatment.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4451-4456
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• 2016

Background: In this study, we examined epidemiological aspects of dynamic changes in incidences of laryngeal cancer in male and female populations in Kazakhstan. Materials and Methods: Primary data were for registered patients with malignant laryngeal tumors in the whole country during the period of 1999-2014. Evaluation of changes in laryngeal cancer incidence in the population of Kazakhstan was performed using component analysis. Results: It was determined that the number of patients with laryngeal cancer in the whole country is decreasing although with conflicting impacts of different factors. Despite population growth (all - ${\Delta}_P=+66.1%$, men - ${\Delta}_P=+70.9%$ and women - ${\Delta}_P=+46.4%$), and aging (all - ${\Delta}_A=+45.1%$, men - ${\Delta}_A=+54.3$ and women - ${\Delta}_A=+22.2$), the reduction in risk of developing the disease (all - ${\Delta}_R=-165.6%$, men - ${\Delta}_R=-170.9%$ and women - ${\Delta}_R=-141.0%$) was overwhelming. Conclusions: This investigation was the first epidemiological study of dynamics of laryngeal cancer by component analysis in population of Kazakhstan. Implementation of the results of the study is recommended in management of anti-cancer activities for laryngeal cancer.

• 대한후두음성언어의학회지
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• 제14권1호
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• pp.16-25
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• 2003

후두암은 유병율이 높지만 조기에 발견하면 90% 이상의 치유율과 발성기능의 보존이 가능하며 현재 음성분석을 이용한 진단법이 시도되고 있으나 정립된 선별검사법은 없는 실정이다. 성문전도검사(electroglottography, EGG)는 성대의 진동양상을 알 수 있는 비침습적 검사로서 발성과 음성합성의 연구에 많이 사용되고 있다. 본 연구는 EGG에서 관찰되는 파라미터들을 다층 퍼셉트론(multilayer perceptron)구조의 신경회로망(artificial neural network)으로 감별하는 기법을 이용하여 후두암 감별법에 대한 연구로서 부산대학교병원을 내원한 후두암 환자 10명과 양성후두질환 26명을 대상으로 새로 고안한 Electroglottograph(v1.0)를 이용하여 검사하고 이의 임상적 유용성을 평가하였다. EGG 파라미터인 closed quotient(CQ), speed quotient(SQ), speed index(SI), fundamental frequency(F0), Jitter, Shimmer 등은 MATLAB 6.5 (Mathwork, Inc.)로 작성한 분석 프로그램을 이용하여 추출하였다. 각 환자에서 추출된 EGG 파라미터들을 다층 퍼셉트론 구조의 신경회로망으로 감별하였다. CQ는 각 질환군 간에 유의한 차이가 없었지만 SQ, SI, Jitter, Shimmer 등은 성대질환의 특성에 따라 유의한 차이를 보였다. 신경회로망에서 감별한 결과 CQ를 제외한 SQ, SI, Jitter, Shimmer 등에서 71.3-90%의 후두암의 감별율을 보였다. 또한 SQ, SI, Jitter, Shimmer를 3개씩 조합한 실험에서는 SQ-Jitter-Shimmer와 SQ-SI-Shimmer의 후두암의 감별율이 93%로 가장 높았고, SQ-SI-Jitter 90.9%, SI-Jitter-Shimmer 88.6%로 전체적으로 85% 이상의 높은 감별율을 나타내었다. 이러한 결과는 EGG검사와 신경회로망을 이용한 양성과 악성 후두질환의 감별이 가능함을 시사한다. 향후 성대 질환의 병태생리를 대변할 수 있는 파라미터가 추가로 개발되고 분류 알고리듬이 개선된다면 EGG를 이용한 성대질환의 감별 진단이 보다 정확해질 것으로 사료되었다.

• 대한의용생체공학회:의공학회지
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• 제23권3호
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• pp.197-205
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• 2002

본 연구에서는 잡음이 존재하는 공간에서 획득한 음성신호로부터 후두질환을 감별진단 할 수 있는 분류기를 구현하였다. 이를 위해 후두질환 환자로부터 수집한 /아/ 모음에 잡음을 혼입하여 음성 신호를 획득하였고, 여러 가지 후두질환을 감별진단 할 수 있는 파라미터를 추출하였으며. 이를 입력으로 하는 계층적 신경회로망을 구성하여 후두질환을 감별진단 하도록 하였다. 감별진단용 분류기는 다섯 단계의 계층적 신경회로망으로 구성하였다 첫 번째 신경회로망은 정상 양성 후두질환과 악성 후두질환을. 두 번째 신경회로망은 정상과 양성 후두질환을 감별진단 하도록 하였다 그리고 세 번째 신경회로망은 양성 후두질환 중 후두용. 성대결절 후두마비를 감별진단 하도록 하였으며. 네 번째와 다섯 번째 신경회로망은 성문암 1-4기를 감별진단 하도록 구성하였다. 분류기에 적용된 신경회로망은 다층퍼셉트론 구조로써 역전파 알고리듬으로 학습시켰으며, 선형변환 표준점수변환 등 전처리과정을 적용하여 분류기의 성능을 개선하였다. 후두질환의 감별진단 결과 후두용 88.23%. 정상. 성대결절. 후두마비 100%. 성문암 1기 90%, 성문암 2-4기 100%의 감별진단율을 관찰할 수 있었다.

• 대한후두음성언어의학회지
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• 제30권2호
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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.

• 대한후두음성언어의학회지
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• 제19권2호
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• pp.142-145
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• 2008

Background and Object: The aim of this study is to evaluate the change of patient's subjective voice handicap index (VHI) and acoustic parameters before and after laryngeal microsurgery for benign vocal cord disease. Materials and Method: We analyzed 78 patients who received laryngeal microsurgery for benign vocal cord disease from January 2004 to February 2007 retrospectively. There were 28 vocal polyp, 40 vocal nodule, 5 intracordal cyst and 5 Reinke's edema. Jitter, shimmer, harmony to noise ratio (HNR) were analyzed before surgery and 2-3months after surgery using the Doctor's speech science program. The voice handicap index introduced by the Pittsburgh Voice Center was used to examine patient's subjective change of voice quality. Results: Acoustic parameters of jitter, shimmer and HNR were improved in patients with vocal polyp and vocal nodule after surgery. The acoustic parameters were not improved in patients with Reinke's edema, statistically. Only jitter was improved significantly in patients with intracordal cyst (p<0.05). The VHI was significantly improved after surgery. The change of jitter and shimmer was significantly correlated with the change of VHI after surgery. Conclusion: The acoustic parameters and VHI were significantly improved in patients with benign vocal disease after laryngeal microsurgery.

• 대한후두음성언어의학회지
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• 제22권1호
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• pp.30-33
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• 2011

Laser is a relatively recent addition to laryngeal surgery. Since their invention, laser use and applications have expanded rapidly. The use of lasers in surgery has offered a time- and cost-efficient alternative to cold surgical techniques and has been used in the treatment of numerous laryngeal pathologies, including stenoses, recurrent respiratory papillomatosis, leukoplakia, nodules, malignant laryngeal disease, and polypoid degeneration (Reinke's edema). Despite the notable benefits, laser surgery is not without disadvantages. Laser heat can increase scarring and cause damage to adjacent tissue. With laser laryngeal microsurgery, there is potential for airway fire, endolaryngeal bleeding, perichondritis, chondritis, granuloma, surgical emphysema, laryngeal stenosis and web formation, postoperative edema and swallowing problem. Surgeons should be known about these complications and could manage properly.