• Proceedings of the KSLP Conference
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• 2009.03a
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• pp.15-15
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• 2009

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.1
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• pp.25-29
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• 2016

Background and Objectives : The clinical reports for the treatment of vocal fold scar and sulcus vocalis are limited, also there is no best one for the treatment of them. This study is to evaluate the effect of Injection laryngoplasty (IL) for the treatment of vocal fold scar and sulcus vocalis. Materials and Methods : from January 2013 to May 2015, the Nineteen patients who were diagnosed as vocal fold scar, sulcus and atrophy, and underwent IL, were engaged in this study. Clinical information and voice parameters were analyzed by retrospective chart review. Pre and post voice parameters were compared. Results : Subgroups of diagnosis were classified into sulcus vocalis for 12 patients, vocal fold scar for 5, and atrophy for 2. IL was performed under local anesthesia through cricothyroid membrane except one patient. Atesense$^{(R)}$, Radiessess$^{(R)}$, and Rofilan$^{(R)}$ were used as injected materials in 9, 9, and 1 patients respectively. Maximal phonation time (p=0.0124), dynamic range (p=0.0028), pitch range (p=0.0141), voice handicap index (p=0.028), glottal closure (p=0.0229), and mucosal wave (p=0.0132) had significant improvement for post-IL voice assessment than Pre-IL. While GRBAS, Mean flow rate, Jitter, Shimmer, Harmony to Noise ratio didn't have improvement. Conclusion : IL is a feasible option for the treatment of glottis incompetence with normally mobile vocal folds such as sulcus vocalis and vocal fold scar.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.119-125
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• 2011

Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.2
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• pp.119-123
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• 2012

Background and Objectives : Sulcus vocalis could be classified into type I, type IIa, and type IIb. There have been a little reports about voice quality and treatment results related with types of sulcus vocalis. The authors conducted an analysis of voice and treatment according to different types of sulcus vocalis. Materials and Methods : This study was based on a retrospective chart review. The sulcus types were classified into type I and type II. Objective and subjective voice assessments were analyzed. Patients were treated individually with voice therapy, percutaneous steroid injection, and injection laryngoplasty. Comparison was performed on the voice difference between type I group and type II group, and between pre-treatment and post-treatment of each types. Results : One hundred and one patients were enrolled into this study, and 49 patients were type I and 52 patients were type II. Type I group showed longer mean maximal phonation time (MPT) than type II group, although other voice parameters didn't show any difference between two groups. Even after the management, almost all of the voice parameters didn't show improvement except MPT of type II group. Conclusion：Although the type I sulcus has been known as a non-pathologic lesion, it can result in some degree of voice change and discomfort, and thus need an active management. In this study, voice therapy, percutaneous steroid injection, and injection laryngoplasty showed limited effect to the both types of sulcus vocalis. Further studies for management of sulcus vocalis were needed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.1
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• pp.13-15
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• 2014

Presbyphonia is defined as voice change caused by aging. Since presbyphonia is one of the natural aging processes, the treatment should be considered for the patients complaining communication difficulties. The treatment should not only target on presbylaryngis, but also on underlying systemic conditions such as lung function, neurological diseases and medications. Therefore, the treatment for the patients with presbyphonia should be multidisciplinary including underlying disease control, voice therapy and surgical treatment. Although various experiments on treatment of presbylaryngis are currently being tried, repeated injection laryngoplasty is still playing an important role because presbyphonia is destined to get worse over time.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.2
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• pp.110-117
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• 2009

Vocal fold paralysis continues to be a dominant topic in laryngology. This review article discusses the management principle of patients suffering from unilateral vocal fold paralysis. There are currently some main methods ; voice therapy ; injection laryngoplasty ; laryngeal framework surgery ; reinnervation procedures.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.2
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• pp.152-155
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• 1998

Laryngeal framework surgery to improve change the voice is a challenging development in phoniatric surgery. Basically two categories can be distinguished : (1) attempted medialization of the vocal fold, as for the treatment of paralytic dysphonias (2) adjustment of the vocal fold's tension of transsexuals or mutational dysphonia. Vocal pitch can be elevated by various surgical technique 1) cricothyroid approximation 2) A-P expansion of the thyroid ala 3) longitudinal incision in the cords 4) intrachondral injection of the steroid, and 5) evaporation of the cords by $CO_2$ laser. We have experienced a case of pitch elevation procedure after transsexual operation. After transsexual operation, he had received anterior commissure laryngoplasty modified from Le Jeune with no change in voice pitch(Fo=110Hz). 8 monthes later, he had received cricothyroid approximation resulting in pitch elevation(Fo=160Hz).

• Proceedings of the KSLP Conference
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• 2017.04a
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• pp.87-87
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• 2017

• Proceedings of the KOR-BRONCHOESO Conference
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• 1991.06a
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• pp.36-36
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• 1991

기도흡인은 후두의 고유기능중 방어기능을 소실함으로써 지속되는 경우 하기도에 치명적인 손상을 초래하게된다. 기도흡인에 대한 치료는 고식적 치료법과 수술적 치료법으로 대별되는데 일반적으로 고식적으로 치료법이 우선적으로 선택되어지고 있으나 흡인의 정도가 심하여 하기도에 폐렴, 무기폐 등의 위급한 합병증을 유발하거나 그 원인이 비가역적이어서 탈진 또는 악액질을 초래하는 경우 부득이 수술적 요법율 선택하게 된다. 수술적 요법의 선택시기에 대하여는 논란이 많으나 현재까지는 고통을 받고있는 환자의 상태에 따라 결정되고 있는 실정에 있다. 저자들은 최근 5년간 경험한 만성 기도흡인 환자 6례에 대하여 수술적 요법 즉, cricopharyngeal myotomy 1례, cricopharyngeal with medialization laryngoplasty 1례, laryngeal suspension with cricopharyngeal myotomy 2례, laryngeal diversion 1례, total laryngectomy 1례를 각각 시행함으로써 얻은 치료경험을 분석 검토하여 만성 기도흡인에 대한 치료상의 문제점과 보다 효율적인 치료법의 선택에 도움을 얻고자 문헌고찰과 함께 보고하는 바이다.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.2
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• pp.56-60
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• 2020

Vocal fold injections are usually performed with a patient wake in an office under local anesthesia. For comfortable and safe office-based procedures, thorough anesthesia and premedication should be provided to the following three regions; nasal cavity, oropharynx, and larynx. Topical lidocaine is most widely used anesthetics on office based procedure. Lidocaine has a low to intermediate potency, 45 minutes to 60 minutes' duration of action, and onset of sufficient anesthesia within 90 seconds of topical administration. Tetracaine, prilocaine, ropivacaine, and bupivacaine also have been used in the office-based procedures. Nasal decongestant, oxymetazoline, is also used for widening nasal cavity by constriction of nasal mucosa. The amount of topical and local anesthetics used in vocal fold injection rarely exceeds toxic doses. The physician should know proper anesthesia techniques and must be familiar with the safe dose and complication of all anesthetics used.