• 대한의용생체공학회:의공학회지
• /
• 제25권5호
• /
• pp.343-349
• /
• 2004

전기성문전도는 발성시에 성문의 진동이 전기적 임피던스를 이용하여 검출되는 신호이다. 본 연구는 이러한 전기성문전도를 기록하기 위한 장비를 구현하고 음성분석 및 후두질환 진단에 대한 적용생을 평가하고자 하였다. 전기성문전도의 하드웨어는 2 쌍의 링전극, 동조증폭기, 검파기, 저역통과필터, 자동이득조절부 등으로 구성되며, 2.7MHz의 반송파 신호를 이용하고 진폭 변조 방식의 검파를 통해 임피던스 신호를 추출하도록 하였다. 추출된 신호는 PC 사운드 카드의 라인 입력을 통해 샘플링되고 양자화되었다. 검출 신호를 분석하기 위한 파라미터는 패래 시간을(CQ), 개폐 속도율(SQ), 개폐속도지수(SI), 성대진동 주파수(F0), 성대진동 주파수변동지수(Jitter), 성대진동 진폭변동지수(Shimmer) 등을 추출하였다. 전기성문전도를 분석한 결과, F0가 증가할수록 CQ는 커지고, SQ와 SI는 작아지는 경향을 보였으며, 전기성문전도와 음성 선호의 기본주파수가 일치함을 알 수 있었다. CQ, SQ, SI는 정상인과 후두암 환자를 비교한 결과 유의한 차이를 보였다. 이러한 결과는 성대의 운동을 관찰할 수 있는 휴대용 전기성문전도 계측기의 구현이 가능하게 하였고, 성대 기능 이상 검사가 가능함을 시사하였다.

• 대한기관식도과학회:학술대회논문집
• /
• 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
• /
• pp.14.4-15
• /
• 1983

이비인후과영역의 악성종양중 가장 많은 빈도를 보이는 후두암의 외과적료법으로는 1873년 Billroth가 처음으로 후두전적출위을, 1873년 H. B. Sands가 후두부분절제술을 시행한 이래 항생제료법, 수혈 및 보다 안전해진 마취 등의 전반적인 진보로 수술후 보다 좋은 예후를 가져왔다. 후두의 임파계는 구획되어 있는 해부학적 특성이 있기 때문에 후두부분절제술의 시행을 가능케 하였으며 이러한 후두부분절제술은 후두전적출술에 비하여 적응증이 다르긴 하나 환부를 제거함과 동시에 발성작용, 호흡작용 및 방어작용등의 기능적인 면을 보존시킬 수 있는 장점이 있다. 최근 수술적요법은 화학요법, 방사선료법 등과 병합으로 재발의 빈도를 줄이고 5연생존율을 증가시켰다. 저자들은 1980연부터 1982연까지 고대부속병원 이비인후과에 내원한 후두암환자중 후두부분절제술의 적응이 되는 8예를 경험하였다. 이들의 발병부위는 후두개 2예, 양측성대 전 1/3부위 2예, 우측성대 전 1/3부위 및 전연합부 1예, 우측후두실 1예, 좌측성대 중 1/3부위 2예로서 이들에 시행한 후두부분절제술에 대하여 문헌적 고찰과함께 보고하는 바이다.

• 대한후두음성언어의학회지
• /
• 제33권2호
• /
• pp.110-114
• /
• 2022

IgG4-related disease is a fibroinflammatory condition by infiltration of IgG4-positive plasma cells that often presents as a tumorous lesion. This disease can affect nearly every organ system. After the pancreas, the head and neck region is second most common site for presentation of IgG4-related disease such as Mikulicz's disease, Küttner tumor. The involvement of IgG4-related disease in laryngeal lesions is extremely rare. We have experienced a case of IgG4-related disease with pseudotumor formation in the larynx that is suggestive of malignancy in radiologic findings. But the pathology findings was finally confirmed as IgG4-related disease. Oral treatment with prednisolone was initiated, and the edematous mass reduced in size without permanent functional impairment of vocal fold mobility. We report our experience with a literature review.

• 대한후두음성언어의학회지
• /
• 제27권2호
• /
• pp.78-83
• /
• 2016

Laryngopharyngeal reflux (LPR) disease is an extraoesophageal variant of gastro-esophageal reflux disease that can affect the larynx and pharynx. LPR is associated with symptoms of laryngeal irritation such as throat clearing, coughing, and hoarseness. The main diagnostic methods currently used are laryngoscopy and pH monitoring. The most common laryngoscopic signs are redness and swelling of the throat. However, these findings are not specific of LPR and may be related to other causes or can even be found in healthy individuals. Furthermore, the role of pH monitoring in the diagnosis of LPR is controversial. A therapeutic trial with proton pump inhibitors (PPIs) has been suggested to be cost-effective and useful for the diagnosis of LPR. However, the recommendations of PPI therapy for patients with a suspicion of LPR are based on the results of uncontrolled studies, and high placebo response rates suggest a much more complex and multifactorial pathophysiology of LPR than simple acid reflux. Laryngoscopy and pH monitoring have failed as reliable tests for the diagnosis of LPR. Empirical therapy with PPIs is widely accepted as a diagnostic test and for the treatment of LPR. However, further research is needed to develop a definitive diagnostic test for LPR.

• Journal of Oral Medicine and Pain
• /
• 제26권2호
• /
• pp.121-126
• /
• 2001

Mucous membrane pemphigoid is uncommom disease in oral cavity and synonymous with cicatricial pemphigoid. This disease is caused by autoimmune reaction that autoantibody reacts antigen located in basement membrane and epithelium is separated from underlying connective tissue. It affects female over sixth decade, commonly. Oral mucosa, especially gingiva is common site but conjunctival, nasal, pharyngeal, laryngeal, esophageal, varginal mucosa and skin are involved. Intraoral findings show Nikolsky sign, irregular erythema, erosion, vesicle, and ulceration at mucous membrane. To differentiate from diseases of positive Nikolsky sign, should perform histologic, immunologic test. Histologic features show subbasilar cleft and direct immunologic features show IgG, C3 deposits at basement membrane in linear pattern. Mucous membrane pemphigoid is incurable disease because symptoms are repetitively improved or worsed for several years. Patiens are commonly managed with topical and systemic steroid. To avoid side effects of prolonged steroid therapy and to maintain immunosupressive effects, combination therapy of azathioprine with steroid is effective. This case reports that mucous membrane pemphigoid is diagnosed based on clinical and histologic features, is treated with topical, systemic steroid and azathioprine therapy.

• 대한후두음성언어의학회지
• /
• 제19권2호
• /
• pp.136-141
• /
• 2008

Background and Objectives: Laryngopharyngeal reflux (LPR) is a very common disease among outpatients of department of otorhinolaryngology. Although there are several diagnostic tools for LPR disease and ambulatory 24-hour double-probe pH monitoring is gold standard method, empirical diagnosis by reflux symptom index and reflux finding score (RFS) are mainly used. So we analyzed the relationship between ambulatory 24-hour double-probe pH monitoring and RFS in patients with LPR. Subjective and Method: Fifty patients with LPR symptoms and abnormal RFS and ambulatory 24-hour double probe monitoring were enrolled. Each items and sum of laryngeal reflux score were compared the results of ambulatory 24-hour double-probe pH monitoring in upper (UES) and lower (LES) esophageal sphincter. Results: There were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES (pH<4 and pH<5) and each item and sum of RFS. However, supine time and reflux number of UES (pH<5) were showed the partial correlations with diffuse laryngeal edema and thick endolaryngeal mucus (p=0.03, p=0.01). Although there were no relationship between the results of ambulatory 24-hour double-probe pH monitoring in LES and sum of RFS, the significant correlations presented between granuloma and total time (p=0.008), upright time (p=0.008, reflux number (p=0.049) of LES. Conclusion: Although granuloma among items of RFS showed significantly correlation with the results of ambulatory 24-hour double-probe pH monitoring in LES, there were no significant correlation between the results of ambulatory 24-hour double-probe pH monitoring in UES and LES and items and sum of RFS.

• 대한후두음성언어의학회지
• /
• 제28권1호
• /
• pp.43-47
• /
• 2017

Laryngopharyngeal reflux disease (LPRD) is common in laryngologic practice. In Korea, up to 1 out of every 5 patients who visit otorhinolaryngology clinic is supposed to have LPRD with symptoms and physical findings. Major symptoms of LPRD include hoarseness, cough, reflux symptom and mild dysphagia. Even though LPRD is common, its diagnosis may be difficult, because its symptoms are nonspecific and the laryngeal findings are not always associated with symptom severity. In Recent study, 66.4% of Patient who has LPRD also associated with esophageal motility disorders. Esophageal achalasia is a disease of unknown etiology characterized by an absence of peristalsis in the body of esophagus and nonrelaxing hypertension of the lower esophageal sphincter. Common cause is loss of ganglion cells in Auerbachs plexus. The classic triad of symptoms in achalasia includes dysphagia, regurgitation and weight loss. LPRD and esophageal achalasia have similar symptoms but have different treatment of choice. The Differentiation diagnosis of theses disease is important and should be established by history, radiologic examination and endoscopic examination. We recently assessed a 59-year-old female patient who complained of an epigastric pain, dysphagia and chronic cough. LPRD was initially diagnosed on Laryngoscopic examination and Reflux Symptom Index, but patient was not relieved of any symptoms after treatment of Proton Pump Inhibitor for 3 months. After high resolution manometry, esophageal achalasia was finally diagnosed. We report this case regarding the diagnosis and treatment with review of literatures because we have to think about esophageal motility disorders as a differential diagnosis in laryngology.

• 대한기관식도과학회지
• /
• 제10권2호
• /
• pp.72-75
• /
• 2004

Pemphigus vulgaris is a rin, chronic intraepidermal bullous disease with potentially fatal outcome. Oral lesions precede skin lesions in at least $70\%$ of cases, and in cutaneous disease, concomitant oral lesions are encountered in $90\%$ of patients. This disorder involve the skin and mucous membranes, especially the oral and pharyngeal mucosa, but may also involve the nasal, oropharyngeal, laryngeal and esophageal mucosa. Oral lesions are initially vesicobullous but rapidly rupture, leaving a painful erosion that shows little tendency to heal. Pemphigus vulgaris affecting the oral mucosa is still diagnosed only after considerable delay, because oral ulceration in common, and clinicians believed the lesions to be caused by more common conditions such as recurrent aphthous stomatitis rather than a rare disorder such as pemphigus vulgaris. The definitive diagnosis of pemphigus vulgaris should be undertaken as early as possible, so that treatment can be started at an earl·y stage. Because of the presence of nonspecific oral ulcer, high degree of suspicion is often required to ultimately make the diagnosis of pemphigus vulgaris and then we report a case of pemphigus vulgaris with a literature review.

• 대한기관식도과학회지
• /
• 제9권1호
• /
• pp.30-38
• /
• 2003

Cancers of the cervical esophagus occur uncommonly, but treatment is remaining a challenging problem and surgery demands special knowledge of abdominal, thoracic, and neck surgery. The primary risk factor is chronic heartburn, leading to a sequence of esophagitis, Barrett's esophagus, reflux esophagitis and etc. Among the various treatment modalities, Surgery is still a mainstay of treatment. The main aim of surgery is not only oncologically adequate resection but also preservation or restoration of physiologic functions, such as deglutition and phonation. Surgical treatment of cervical esophageal cancer is influenced by special problems arising from tumor factors, patient factors and surgeon factors. Complete clearance of loco-regional disease and prevention of postoperative complications are of particular importance for the improvement of long-term survival in patients with these cancers. So the cervical and thoracic extension of these tumors usually required an extensive lymphadenectomy with primary resection. Radical resection of the primary site almostly include sacrifice of the larynx, but the voice could be rehabilitated with various methods, such as tracheoesophageal prosthesis or tracheoesophageal shunts, etc. Restoration of the esophageal conduit can be performed using gastric or colon interposition, radial forearm free flap or jejunum free flap, etc. Recently, the advances of radiation therapy and chemotherapy will enable less extended resections with greater rates of laryngeal preservation. At initial presentation, up to 50％ to 70％ of patients will have advanced locoregional or distant disease with virtually no chance for cure. Patients with advanced but potentially resectable esophageal cancer are generally treated by surgery with some form of neoadjuvant chemotherapy, radiotherapy, or both, with 5-year survivals in the 20％ to 30％ range. So the significant adverse factors affecting survival should be taken into account to select the candidates for surgery.

• 대한후두음성언어의학회지
• /
• 제33권3호
• /
• pp.142-155
• /
• 2022

Diagnosis using voice is non-invasive and can be implemented through various voice recording devices; therefore, it can be used as a screening or diagnostic assistant tool for laryngeal voice disease to help clinicians. The development of artificial intelligence algorithms, such as machine learning, led by the latest deep learning technology, began with a binary classification that distinguishes normal and pathological voices; consequently, it has contributed in improving the accuracy of multi-classification to classify various types of pathological voices. However, no conclusions that can be applied in the clinical field have yet been achieved. Most studies on pathological speech classification using speech have used the continuous short vowel /ah/, which is relatively easier than using continuous or running speech. However, continuous speech has the potential to derive more accurate results as additional information can be obtained from the change in the voice signal over time. In this review, explanations of terms related to artificial intelligence research, and the latest trends in machine learning and deep learning algorithms are reviewed; furthermore, the latest research results and limitations are introduced to provide future directions for researchers.