• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.59-63
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• 1998

Background： Unilateral vocal cord paralysis(UVCP) by recurrent laryngeal nerve injury is one of the common laryngological diseases. Objectives : We attempted to study the clinical feature and the causes of UVCP and also tried to investigate what is to be the initial approach for determining the causes of unknown-origin UVCP Materials and methods The charts of 82 patients with the diagnosis of UVCP were reviewed. The records were analyzed for patient's gender and age, the status of paralysed vocal cord, the crucial tests for the diagnosis, and the etiologies. Results : forty-nine(59.8%) male and 33(40.2%) female patients were included in this study. The age group of sixth decade was most commonly involved. Most of the cases showed paramedian position of palsy, and the left side(59.8%) was more frequently attacked. The most common cause of UVCP in this series was the unknown origin, followed by the surgical trauma and neoplasms. The etiologies of the six(12.5%) unknown-cause cases were found with the further evaluation, with the most useful test being a CT scan. Conclusion： Chest X-ray, esophagography, and CT scan should be included in the mandatory initial investigation of patients with unknown-origin UVCP

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.2
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• pp.49-55
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• 2020

Evaluating the patient's voice before thyroidectomy is useful for the purpose of identifying patients with vocal cord paralysis without symptoms, identifying other patient's voice abnormalities, and whether it is related to voice disorders that may occur after surgery. Also voice evaluation after thyroid surgery is helpful in diagnosis, treatment, and rehabilitation and follow-up of voice disorders that occur without clear nerve damage after thyroidectomy. And it is helpful for rapid recovery through active early rehabilitation treatment for patients who complain of speech impairment without paralysis. In particular, neck exercise can improve the adhesion of the surgical site and increase the range of motion of the neck as well as improve subjective neck discomfort. In addition, hearing, voice and breathing functions should be improved, and voice hygiene education and counseling should be provided. Vocal cord injection is the first treatment option for unilateral vocal cord palsy. By establishing a protocol for voice disorders before and after thyroid surgery and providing appropriate treatment, the quality of life of patients can be improved.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.1
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• pp.30-39
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• 2003

Background and Objectives : Patients with pathologic voice often concern about recovery of voice after surgery. In our investigation, we give controlled values of three parameters of voice synthesis program of Dr. Speech Science. such as jitter, shimmer, and NNE(normalized noise energy) which characterize someone's voice from others and deviced a method to synthesize the predicted voice after performing operation. Subjects and Method : Values of vocal jitter, vocal shimmer, and glottal noise were measured with voices of 10 vocal cord Paralysis and 10 vocal Polyp Patients 1 week Prior to and 1 month after the surgery. With Dr. Speech science voice synthesis program we synthesized 'ae' vowel which is closely identical to preoperative and post-operative voice of the patients by controlling the values of jitter, shimmer, and glottal noise. then we analyzed the synthesized voices and compared with pre and post-operative voice. Results : 1) After inputting the preoperative and corrected values of jitter, shimmer, and glottal noise into the voice synthesis Program, voices identical to vocal Polyp Patients' Pre- and Postoperative voices withiin statistical significance were synthesized 2) After elimination of synergistic effects between three paramenter, we were able to synthesize voice identical to vocal paralysis patients' preoperative voices. 3) After inputting only slightly increased jitter, shimmer into the synthesis program, we were able to synthesize voice identical to vocal cord paralysis patients' postoperative voices. Conclusion : Voices synthesized with Dr. Speech science program were identical to patients' actual pre and postoperative voice, and clinicians will be able to give the patients more information and thus increased patients cooperability can be expected.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.3 no.1
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• pp.13-21
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• 1989

A clinico-statistical analysis was performed on 1373 cases who complained of hoarseness at the Dept. of Otolaryngology of Ewha Womans University hopital during the past 10 years from fan 1975 to Dec 1984 and the following results were obtained. 1) Among total of 44,912 who visited the Dept. of Otolaryngology. the patients with hoarseness were 1373 cases(3.1%). 2) Among total of 1373 cases, male were 586 and female were 787, the ratio being 1:1.3. 3) The underlying diseases causing hoarseness in order of frequency were acute laryngitis 374 cases(27.2%), chronic laryngitis 325 cases(23.7%), vocal nodule 248 cases(18.1%), vocal polyp 130 cases(9.5%), vocal cord paralysis 101 cases(7.4%), laryngeal cancer 24 cases(1.7%). 4) The highest incidence of age causing hoarseness in order of frequency were 3rd decade 368 cases(26.8%) 2nd decade 312 cases(22.7%) 4th decade 297 cases(21.6%), 5) The highest incidence of age for underlying diseases in order of frequency were as that follows: acute laryngitis in 2nd decade 114 cases(30.5%), chronic laryngitis in 3rd decade 92 cases(28.3%), vocal nodule in 3rd decade 81 cases(32.7%), vocal polyp in 4th decade 38 cases(29.2%), vocal cord paralysis in 5th decade 19 cases(18.8%), laryngeal cancer in 5th decade 13 cases(54.2%). 6) Number of the patients who came the hospital within 10 days after the onset of hoarseness were 272 cases(19.8%), 15 cases(1.1%) had medical attention for first time 10 years after hoarseness. 7) The highest incidence of the duration from the onset to consultation for the underlying diseases were as that follows: acute larynsitis within 10 days 205 cases(54.8%), chronic laryngitis 3M-6M 76 cases(23.4%), vocal nodule 3M-6M 55 cases(22.2%) vocal polyp 6M-lYr 32 cases(24.6%), vocal cord paralysis 3M-6M 20 cases(19.8%)

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.20 no.1
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• pp.68-70
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• 2009

Acromegalic patients can develop mild upper airway obstruction. However, the limitation of both vocal folds mobility developing dyspnea is rare. We report a case with bilateral vocal cord paralysis associated with acromegaly. The patient visited our clinic presenting dyspnea showing bilateral vocal cord hypomobility in laryngoscopy. The patient underwent a tracheostomy and a transsphenoidal resection of the pituitary adenoma. Thereafter, laser cordotomy with medial arytenoidectomy was done for the permanent treatment of glottal obstruction. The tracheotomy canula was successfully removed one month after the surgery.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.1
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• pp.32-36
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• 2010

Background : Vocal fold injection using autologous material (fat or collagen) is very useful. However, Autologous material have variable resorption times and results, Plasma gel is a new injection material. The purpose of this study is to introduce a new injection material and discuss the effectiveness and complications. Subjects and Method: Eleven cases with vocal cord paralysis were analyzed after plasma gel injection, The plasma gel was acquired from patient's own blood. The preoperative and postoperative parameters including maximum phonation time (MPT) and subject aspiration score were analyzed. Results: There was a significant improvement in MPT and aspiration score in the case of vocal cord palsy. There was only one laryngeal complication. Conclusion : According to these preliminary results, the injection laryngoplasty with Plasma gel is a simple, safe, cheap procedure for temporally vocal fold palsy.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.2
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• pp.129-134
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• 2005

Background and Objectives : Artecoll(R) is an injectable soft tissue filler, which is a suspension of polymethylmethacrylate microspheres in $3.5\%$ bovine collagen solution. The authors aimed to determine the clinical of Artecoll of Artecoll(R) as an injection material into the vocal fold to correct the glottal insufficiency caused by unilateral vocal cord paralysis. Materials and Methods : Forty-one consecutive patients with unilateral vocal cord paralysis received percutaneous Artecoll injections under local anesthesia. Acoustic, aerodynamic and stroboscopic analyses were prospectively provided before, 1 week and 3 months after injection. Perceptual GRBAS grading by speech language pathologists and subjective ratings of the hoarseness and aspiration by the patients were also obtained. Results : Aerodynamic parameter(maximal phonation time) were significantly improved after the injection (p<0.05). Acoustic parameters (jitter and shimmer) were improved at the 3rd month follow-up. GRBAS uading and patients own subjective scaling of hoarseness and aspiration also showed significant improvement (p<0.05). Early or delayed significant side effects were not observed. Conclusion : Vocal fold injection with Artecoll is a convenient, safe and useful method of temporarily correcting the glottal insufficiency. Further long-term follow-up studies will answer the usefulness and safety of the Artecoll injection laryngoplasty.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.10.1-10
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• 1982

The use of phonosurgery in the recent development of laryngomicrosurgery has enabled the restoration of a normal voice in respect to functional laryngeal surgery which in Korea in the past limited to simple removal of benign laryngeal tumor such as laryngeal polyp or nodules and cordal injection of $Teflon^{{\circledR}}$ for the treatment of recurrent nerve paralysis under the vision of suspension laryngoscopy. Performance of phonosurgery for the treatment of cord paralysis, mutational dysphonia, vocal cord atrophy, hyperkinetic dysphonia and sulcus vocalis is a happy event in the view point of development of phonosurgery in Korea. In this aspect thyroplasty to change the position and physical characteristics of the cord outside the glottis instead of the direct handling of the vocal cord through direct endoscopy is popular. Among the 4 types of thyroplasty, classified by Insshiki(1974), type I thyroplasty(1ateral compression of vocal cord) and type IV thyroplasty(lengthening of vocal cord) were effective in the treatment of unilateral vocal cord paralysis. Advantages of this operation are the fine adjustment of the degree of lateral compression under local anesthesia according to the phonation of the patient during operation and avoidance of dyspnea and intralaryngeal hemorrhage due to the manipulation outside the internal perichondrium of the thyroid cartilage. We did 7 cases of thyroplasty for the treatment of unilateral vocal cord paralysis in the 7 months from September 1981 to March 1982. Before the operation aerodynamic study, psychoacoustical evaluation, stroboscopy and sound spectrographic analysis were done. Two months after the operation the above procedures were performed again. Results of preoperative and postoperative examination were compared and the following results were obtained. 1) In the aerodynamic study, maximum phonation time increased to 158% of the preoperative value and the phonation quotient and the mean flow rate decreased to 58% and 54% of preoperative values. 2) The degree of hoarseness improved in the psychoacoustical evaluation and the glottic chink during phonation was decreased in the stroboscopic examiantion. 3) In the sound spectrographic analysis, periodicity was much restored and noise distribution decreased especially in the high frequency area.

• 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.24 no.2
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• pp.125-127
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• 2013

Infection by aspergillus, which is a kind of mold, or a filamentous fungus, occurs rarely in larynx. Furthermore, primary laryngeal aspergillosis without any other airway tract extension and without any generalized immune deficit is extremely rare. We present a case of primary aspergillosis on vocal cord in a 72-year-old male who had no history of immune deficiency, voice abuse or steroid use.