• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.14 no.1
• /
• pp.5-9
• /
• 2003

Introduction : Laryngomicrosurgery(LMS) is frequent procedure applying to benign and early malignant larygeal disease such as vocal cord polyp, nodule and early glottic cancer. LMS has been known as safe procedure and short time consuming treatment. So few reports about complications in LMS was done. In this study, complications and problems from LMS were investigated and reported. Method : From 2000, January to 2001, December, 180 patients who were treated with LMS in Asan medical center were studied by retrograde chart review. Results : In these patients, total 9 patients(5%) were suffered from complication. 4 patients (2%) had teeth injury and 4(2%) were suffered from foreign body sensation in tongue and 1(1%) had hypoglossal nerve injury. Main mechanism of complications is thought by pressure injury by laryngoscope blade. No definite correlation between procedure and complication was observed. Conclusion : There are few neural complications with LMS such as lingual and hypoglossal nerve injury. Before operation of LMS, warning and informing of complications by mechanical stress must be done. Gentle procedure and short operation time are necessary to avoid these problems. And patients who have risk factors of oral complications such as dental disease or dental prosthesis must have dental evaluation and treatment before LMS procedure.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.28 no.2
• /
• pp.96-99
• /
• 2017

Background and Objectives : The management of Reinke's edema includes usually medical treatment and voice therapy. Laryngomicrosurgery (LMS) is also necessary, especially to improve airway obstruction. However, voice outcome after LMS has not been determined well. The aim of this study was to evaluate effectiveness of LMS for Reinke's edema and analyze the voice outcomes after LMS. Materials and Methods : Twenty-five patients with Reinke's edema who underwent LMS from September 2007 to December 2016 were enrolled in this study. We analyzed reflux finding score (RFS), reflux symptom index (RSI), and acoustic parameters before and after surgery. Results : Male was 15 (60%) and female was 10 (40%), and mean age was 49.6 years. Preoperative mean value of RFS decreased significantly up to 3 months after LMS ($18.3{\pm}2.2$ and $10.0{\pm}2.2$ at preoperative and 3 months postoperatively, respectively). The mean value of Jitter decreased significantly before and after surgery ($2.71{\pm}2.81%$ and $1.06{\pm}1.21%$ before and after LMS, p=0.041). The mean value of Shimmer also decreased significantly before and after surgery ($7.97{\pm}3.63%$ and $4.83{\pm}1.85%$, respectively, p=0.006). Conclusion : LMS is effective in the treatment of Reinke's edema. It results in favorable acoustic outcomes and laryngoscopic findings in properly selected patients.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1983.05a
• /
• pp.8.2-9
• /
• 1983

Recently, the laryngomicrosurgery has been done for the removal of benign laryngeal mass and for the improvement of voice. For the evaluation of the effect of the treatment, there must be any objective method such as aerodynamic study, vocal fold vibration study, acoustic analysis, psycho-acoustic evaluation and the neuro-muscular study. The authors evaluated the phoniatric effect of the laryngomicrosurgery for the patients of 15 laryngeal polyps and 9 laryngeal nodules, who received pre-op. and post-op. vocal function study from Jun. 1981 to Mar. 1983. The results obtained were as follows ; 1) The post-op. mean value of the maximum phonation time was increased 40 % in the unilateral polyps, 62 % in the bilateral nodules and 18 % in the unilateral nodules. 2) The post-op. mean value of the phonation quotient was decreased 25 % in comparison with pre-op. value in the case of the bilateral polyps, 26 % in the unilateral polyps, 55 % in the bilateral nodules and 12 % in the unilateral nodules. 3) The post-op. mean value of the mean air flow rate was decreased 27 % in comparison with the pre-op. value in the case of the bilateral polyps, 25 % in the unilateral polyps, 65 % in the bilateral nodules, 25 % in the unilateral nodules. 4) The glottic chink of the 10 cases of polyps among the 11 cases were disappeared, and the glottic chink of the 5 cases of nodules among 7 cases were also disappeared after surgery. 5) The pre-op. hoarseness of the 10 cases of polyps among the pre-op. hoarseness of the 11 cases of polyps were changed to clear and the 3 cases of nodules were also changed to clear.

• Proceedings of the KSLP Conference
• /
• 2017.04a
• /
• pp.6-9
• /
• 2017

• Korean Journal of Head & Neck Oncology
• /
• v.31 no.2
• /
• pp.43-45
• /
• 2015

Angiomyolipoma is a benign tumor that is composed of adipose tissue, blood vessels and smooth muscle. The kidney is the most common location of this tumor. In the larynx, angiomyolipoma has been rarely reported in the literature. We describe the patient of 64-year-old male with an angiomyolipoma arising from the vallecula. The tumor had a smooth surface with numerous small vessels and showed heterogeneous contrast enhancement on CT. The tumor was not adhesive to surrounding tissue and was completely removed by laryngomicrosurgery with $CO_2$ laser. Microscopically, the tumor is composed of mature adipose tissue, tortuous thick walled blood vessels and thick bundles of smooth muscle.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.28 no.2
• /
• pp.131-134
• /
• 2017

Sulcus vocalis remains a surgical challenge despite many recent advances in laryngomicrosurgeries. We previously reported that 585-nm Pulsed dye laser (PDL) exerts favorable outcome in treatment of sulcus vocalis due to its therapeutic effects of collagen rearrangement and improved wound remodeling. In spite of the usefulness of PDL glottoplasty for treating sulcus vocalis, the device is no more available in the country. It prompted us to focus another angiolytic laser ; 532-nm KTP laser which has similar mechanisms of action and has been used for treatment of other laryngeal lesions elsewhere. Herein, we present a case of sulcus vocalis successfully treated with KTP laser. A patient underwent laryngomicrosurgery with angiolytic KTP laser (KTP glottoplasty) by the same surgical procedure with PDL glottoplasty. After the surgery, the patient presented improved voice outcome in time without complications.

• Korean Journal of Otorhinolaryngology-Head and Neck Surgery
• /
• v.61 no.11
• /
• pp.619-623
• /
• 2018

Mucosal bridges of vocal fold have been described as a parallel band to vocal folds with the presence of sulcus vocalis. However, the type of mucosal bridge crossing each vocal fold has not been well documented in the literature. Herein, we present two cases of mucosal bridge found in the vocal fold connecting the mid-portions of true vocal folds. Two patients who had no history of laryngeal trauma, surgery or oro-tracheal intubation visited our clinic due to voice change. Laryngoscopic examination revealed that they had a mid-portion mucosal band without any other mucosal lesions. Two patients underwent laryngomicrosurgery with pulsed dye laser. After the surgery, they showed significant improvement of voice quality.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.33 no.2
• /
• pp.115-118
• /
• 2022

Fibrolipomas are a rare microscopic variant of lipomas, characterized by mature adipose tissue interspersed with dense fibrous connective tissue. These lesions are rarely observed in the head and neck region and represent <0.6% of all benign tumors of the larynx and hypopharynx. Their clinical presentation depends on the location and size of lesions. Patients present with variable symptoms; however, fibrolipomas of the larynx and hypopharynx are clinically important because these tumors can cause unpredictable airway obstruction, particularly during general anesthesia induction. We present a case of a hypopharyngeal fibrolipoma in a 61-year-old patient with frequent dyspnea, dysphagia, and muffled voice. Laryngoscopy revealed a well-demarcated pedunculated ovoid mass involving the larynx. We performed laryngomicrosurgery using a carbon dioxide laser for surgical excision and subsequent evaluation confirmed the diagnosis of fibrolipoma. We report a case of hypopharyngeal fibrolipoma, together with a literature review.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.33 no.1
• /
• pp.31-36
• /
• 2022

Background and Objectives Proton pump inhibitors (PPIs), mucolytics, and steroids were commonly recommended after phonomicrosurgery to prevent worsening of vocal fold (VF) scar formation and subglottal swelling. However, there is no consensus about whether laryngeal reflux and thick discharge are associated with the voice outcomes following phonomicrosurgery in benign VF lesions. The purpose of this study is to examine voice outcomes of use of PPIs, mucolytics,and steroids after phonomicrosurgery. Materials and Method This randomized controlled study is performed with patients undergoing laryngomicroscopic surgery for VF polyp and cyst. Participants were randomly assigned to 1) no medication, 2) PPIs, 3) PPIs+mucolytics, and 4) PPIs+mucolytics+steroids for 2 months postoperatively. Grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, stroboscopic examination, aerodynamic assessment, acoustic analysis, and Voice Handicap Index-10 (VHI-10) were performed pre- and post-operatively at 2 months. Parameters were compared among four groups. Results Among 85 patients, a total of 50 patients were included. The VHI-10, perceptual and acoustic parameters improved in all groups after surgery. However, there was no significant difference in those parameters among all groups. Conclusion PPIs, mucolytics, and steroids did not significantly influence voice outcomes after phonomicrosurgery in patients with benign VF lesions.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1983.05a
• /
• pp.11.2-11
• /
• 1983

Vocal nodules and polyps are much more frequent in singers, public speakers, teachers and actors. Voice trauma and voice misuse, at times associated with mild inflammatory reaction, appear to be important in their etiology. It is generally agreed that vocal cord nodules and polyps are inflammatory in nature and they arise in the subepithelial layer of loose connective tissue of the vocal cord. Since the junction of anterior and middle thirds of the membranous cord and has the greatest amplitude of vibration. This is the site of predilection for vocal cord nodules. The author performed laryngomicrosurgery for 70 cases of vocal nodules and polyps at Ewha Womans University Hospital during the period of 5 years. The result obtained were as follows ; 1) Surgical excision is not necessarily the best approach because vocal nodules in the early stages will resolve with the simplest voice therapy. 2) In children, surgery is rarely indicated because most nodules in children regress during adolescence. 3) For patients who use their voices professionally, voice therapy is indicated for three months. 4) If after three month of conservative treatment the cord lesion does not improve and the patient it still dissatisfied with his voice, laryngomicrosurgery can then be considered. 5) The small cuffed endotracheal tube in the interarytenoid space helps to keep the cords immobile and in an abducted position. 6) Removal of the nodule shoule be started by gentle retraction posteriorly and as soon as a tear appears anterior to the nodule. 7) On occasion it is preferable to start the dissection with a siccle knife while the nodule is held on the stretch. 8) Voice rest should be maintained for a week following which the free edges of the cords are usually healed.