• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.23 no.1
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• pp.28-32
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• 2012

Vocal fold scar disrupts structure of lamina propria and causes significant change in vocal fold tissue biomechanics, resulting in a range of voice problems that often significantly compromise patient quality of life. Although several therapeutic management have been offered in an attempt to improve vocal fold scar, the ideal treatment has not yet been found. Recently, several tissue engineering technique for vocal fold scar using growth factors, several cells, and scaffolds have been described in tissue culture and animal models. Several growth factors such as hepatocyte growth factor, basic fibroblast growth factor, and transforming growth factor beta 3 for therapy and prevention of vocal fold scar have been studied. Cell types to regenerate vocal folds in scarring tissue have been introduced autologous or scarred vocal fold fibroblast and adult mesenchymal stem cells. Decellularized organ matrix and several hyaluronic acid materials have used as scaffolds for vocal fold scar.

• Proceedings of the KSLP Conference
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• 1998.11a
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• pp.210-210
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• 1998

Vocal fold vibration is essentially the propagation of a mucosal wave, starting from the lower surface of the vocal fold. The mucosal upheaval (MU), where the mucosal wave starts and propagates upward, appears only when the vocal fold vibrates. We investigated the location of the mucosal upheaval in response In variations in vocal fold tension. Vibrations were elicited under three conditions: during bilateral thyroarytenoid (TA) muscle contraction, without TA muscle contraction and during vocal fold lengthening. TA muscle contraction was obtained by direct electrical stimulation of the muscle. The vocal fold was lengthened by cricothyroid (omitted)

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.18 no.2
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• pp.122-128
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• 2007

This study aims to analyze the voices of the patients with voice disorders including vocal fold paralysis, vocal fold cyst and vocal nodule/polyp in the aspect of acoustic phonetics. This study intends to collect subsidiary acoustic data in order to make a speech treatment and an standardization of vocal disorders. Subjects and Methods: The subjects of this study were 64 adult patients who underwent indirect laryngoscopy and laryngostroboscopy, and were diagnosed as vocal fold paralysis, vocal fold cyst or vocal nodule/polyp. Experimental group consisted of 20 patients who were diagnosed as vocal fold paralysis, 21 patients who were diagnosed as vocal fold cyst and had the average age of 42.0 $({\pm}10.03)$ ; and 23 patients who were diagnosed as vocal nodule/polyp and had the average age of 40.9 $({\pm}13.75)$. For the methodology of this study, the patients listed above were asked to sit in a comfortable position at intervals of 10cm apart from the patient's mouth and a microphone, and subsequently to phonate a vowel sound /e/ for the maximum phonation time with natural tone and vocal volume then the sound was directly inputted on a computer. During recording, sampling rate was set to 44,100Hz and the 1-second area corresponding to stable zone except the first and the last stage of waveform of the vowel sound /e/ vocalized by the individual patients was analyzed. Results: First, there was no statistically significant difference in jitter and shimmer between vocal fold paralysis and vocal fold cyst, while there was highly statistically significant difference in them between vocal fold paralysis and vocal nodule/polyp. Second, looking into the mean values obtained from NNE, HNR and SNR results associated with noise ratio, the disease showing the most abnormal characteristics was vocal fold paralysis, followed by cyst and nodule/polyp in order. For NNE, there was statistically significant difference between vocal nodule/polyp, and cyst or paralysis. In other words, it was found that the NNE of vocal nodule/polyp was weaker than that of cyst or paralysis. Similarly, HNR and SNR also showed the same characteristics; there was statistically significant difference between vocal fold paralysis and vocal fold cyst or nodule/polyp, and HNR and SNR values of vocal fold paralysis were lower than those of vocal fold cyst or nodule/polyp. Conclusion: For vocal fold paralysis, the abnormal values of acoustic parameters associated with frequency, amplitude and noise ratio were statistically significantly higher than those of vocal fold cyst and nodule/polyp. This finding suggests that the voices of the patients with vocal fold paralysis are the most severely injured due to less stability of vocal fold movement, asymmetry and incomplete glottic closure. In addition, there was no statistically significant difference in the acoustic parameters of tremor among vocal fold paralysis, vocal fold cyst and vocal nodule/polyp. Further studies need to ascertain reasonable acoustic parameters with various vocal disorders as well as to clarify the correlation between acoustics-based objective tools and subjective evaluations.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.2
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• pp.94-97
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• 2003

Background and Objectives : Bowing of the vocal fold, a bowed edge of the vocal fold results from various disorder causes glottic incompetence resulting in voice disorders. The results of treatment were not satisfactory even though a variety of methods of treatment were applied. The goal of this study is to evaluate of efficacy of the non-surgical, voice therapy in patients with vocal fold bowing. Materials and Method : Twenty two patients of vocal fold bowing not resulting from vocal fold palsy and sulcus vocalis were analyzed. After voice therapy and medical treatment, parameters of perceptual, acoustic, aerodynamic analysis and stroboscopic findings were compared those of pretreatment results. Results and Conclusion : Jitter, shimmer and maximal phonation time were significantly improved and subjective satisfaction was improved in 73% of patients. In the videostroboscopic examination, vocal fold gap was decreased in 27% of patents. The result of this study indicates that voice therapy alone has effect in treatment of vocal fold bowing. Voice therapy is one of the mainstay of treatment of vocal fold bowing.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.2
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• pp.161-166
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• 2000

Background and Objectives : Vocal fold hemorrhage occur by blood accumulation in Reinke's space by vocal trauma. It is mostly asymptomatic, but in some cases it may cause severe dysphonia. It is often seen in patients who use their voice professionally. However, recent changes of life style affected the phonation in general population. We studied to know what are the causes and what are the major factors to affect the vocal fold hemorrhages. Materials and Methods : 19 subjects were evaluated by using of questionaire and laryngoscopic examinations. We evaluated the factors to lead the change in voice directly, underlying causes, occupations and laryngeal findings. Results : The direct causes of the vocal fold hemorrhages were clearing throat, talking, coughing and singing. Reflux laryngitis and upper respiratory infection were the underlying diseases. Vocal fold hemorrhages were developed during the menstruation in 5 patients. Accompanying functional voice disorders were seen in 13 patients, such as, vocal fold nodule, nodule with varix, vocal polyp, Reinke's edema. Patients with reflux laryngitis had the habits of clearing throat as the direct cause of the vocal fold hemorrhages and had hyperkinetic functional voice disorders. Voice abuse was the direct cause of the vocal fold hemorrhages in patients who was in the period of the menstruation. The most common site of the hemorrhage was at the membranous portion of the vocal folds. Conclusions : Authors thought the forceful laryngeal activity was the cause of the vocal fold hemorrhages. And reflux laryngitis and menstruation was the risk factors of the vocal fold hemorrhages.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.97-100
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• 2015

Benign vocal fold lesions, such as vocal nodules, polyps and Reinke's edema, usually result from chronic voice overuse. Conservative management such as voice therapy and pharmacotherapy are used as the primary treatment techniques. The main purpose of voice therapy is to identify and reduce voice misuse to achieve the optimal voice. But complete resolution may not be possible in all patients after voice therapy. Furthermore, some patients with voice-related occupations, voice rest and voice therapy are sometimes difficult, which makes it hard to carry out the treatment. When conservative therapy is ineffective, laryngeal microsurgery can be performed under general anesthesia. However, potential complications following laryngeal suspension and violation of the layered structure of the vocal fold during surgery should be considered before surgery. In recent decades, emerging literatures have demonstrated the potential usefulness of vocal fold steroid injection as an alternative treatment option for benign vocal fold lesions. The most advantageous feature of vocal fold steroid injection is the maintenance of regional anti-inflammatory effects while preventing the potential systemic adverse effects of the steroid. Many non-surgical treatment methods can be conducted using different approaches in the office setting. It can be applied as an alternative treatment modality for the management of various benign vocal fold lesions.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.24 no.1
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• pp.51-54
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• 2013

False vocal fold hypertrophy caused by diverse pathologic lesion, such as laryngeal amyloidosis, laryngeal lipidosis, laryngocele, saccular cyst and sulcus vocalis. False vocal fold hypertrophy, however, is also caused laryngeal structure deformity, irrespective of pathologic lesions. In this article, we report some cases of false vocal fold hypertrophy caused by inward bowing of thyroid cartilage. At the clinic of the department of otorhinolaryngology in Gangnam Severance Hospital, with 3 male complained of hoarseness as subjects, and comfirmed of false vocal fold hypertrophy using the stroboscopy and larynx CT we checked vocal fold and laryngeal structure. Three patients with apparent hypertrophy of false vocal fold were investigated with computerized tomography (CT). In all patients, marked concavity of thyroid cartilage was revealed in CT scan at the level of the false vocal fold, and this deformity of the thyroid cartilage seemed to cause a protrusion of false vocal fold which taken as hypertrophy in stroboscopy. Careful palpation of the larynx and a CT scan taken at the level of the false vocal fold should be useful in determining whether hypertrophy of the false vocal fold is pathologic. For the next articles, It is necessary to discuss for the cause, diagnosis, treatment and prevention of inward bowing of thyroid cartilage.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.10 no.1
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• pp.37-42
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• 1999

The vocal fold has three major function-phonation, respiration and protection, and is richly innervated. The vocal 1314 its autonomic innervation-adrenergic and cholinergic from superior cervical ganglion and the vagus nerve, respectively. The action of both system account for vasoregulation and glandular activity. In e vocal fold several kin of neuropeptides, including SP, CGRP, VIP, TH, NPY, ENK have been reported at the animal including cat or dog. But information regarding the distribution of autonomic nerve fibers containing neuropeptides in the human vocal fold is lacking. Two neuropeptides are of special interest : 1) vasoactive intestinal polypeptide(VIP)that is known to be contained in the parasympathetic(cholinergic) neuron. 2) tyrosine hydroxylase(TH)is located in the cytoplasm of noradrenergic neuron and is the rate-limiting enzyme in noradrenaline synthesis. To understand specific autonomic function of vocal fold we did immunohistochemical examination of VIP and TH in the human vocal fold.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.21 no.1
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• pp.27-31
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• 2010

Mild vocal fold hypomobility is a common finding of which clinical significance is incompletely understood. Recently, electrophysiologic investigations have shown that vocal fold hypomobility is a continuum of neurogenic dysfunction ; partial denervation (paresis), complete denervation (paralysis), and variable degrees and patterns of reinnervation. Despite a sound pathophysiological basis for its existence, interest in and acceptance of the diagnosis of vocal fold paresis is relatively recent. Vocal fold paresis may be a relatively common and often overlooked condition that can be difficult to diagnose since laryngoscopy does not reliably distinguish innocent laryngeal asymmetry from hypomobility caused by paresis. Although not entirely free from error, laryngeal electromyography seems to hold more promise as a means of reliable diagnosis than laryngoscopy, and should be employed systematically in the evaluation of suspected paresis. The means to help most patients with paresis already exists in the repertoire of interventions developed to treat paralysis. However, since the vocal fold retains substantial movement, more conservative treatment strategy is recommended as a first line of treatment. The authors reviewed the representative reports of vocal fold paresis and summarized the controversies and consensus regarding the vocal fold paresis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.12 no.1
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• pp.61-63
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• 2001

The mucosal bridge of the vocal fold is an arch of mucosa, formed by some portion of the vocal fold mucosa which is detached in various extension and length. The etiology is uncertain but some is related to vocal sulcus. Because it affects the voice with variable impact, it must be differentiated from functional voice disorder. We report a case of a mucosal bridge of vocal fold with a vocal polyp treated by microlaryngeal surgery and voice therapy.