• Title/Summary/Keyword: vocal nodules

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Clinical Characteristics of the Intracordal Cysts (성대낭종의 임상적 특성)

  • Cho, Young-Ju;Yang, Yoon-Su;Yoon, Yong-Joo;Kwon, Sam-Hyun;Hong, Ki-Hwan
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.47-51
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    • 2009
  • Background and Objectives: Intracordal cysts may occur secondary to voice abuse and overuse or may be secondary to a remnant of epithelium trapped within the lamina propria. They may occur spontaneously or may be associated with poor vocal hygiene. As the cyst enlarges it can start to significantly affect the vibratory region of the vocal fold. With the advancement of the microsurgical technique and the laryngeal stroboscopy, correct diagnosis of intracordal cyst have been increased. The aims of this study is to review the important clinical characteristics of the intracordal cyst. Materials and Methods: In the present study, 212 cases of the intracordal cysts were treated by the microsurgical technique. These lesions were diagnosed before the operation with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with the findings observed during operations and the results of the biopsies. Results : The intracordal cysts were 212 cases in the 4,20 I patients who underwent laryngeal microsurgery (5.04%). Ductal cysts were 156 cases and epidermoid cysts were 56 cases. The lesions are more frequent in women and anterior third of true vocal cord is more frequently involved site. With the preoperative laryngoscopic examination, the intracordal cysts were mostly misdiagnosed as other disease of the vocal cord such as vocal polyps or nodules. And main cause of intracordal cysts was thought of vocal abuse. From view of the surgical approach, Ductal cysts was difficult to remove completely than epidermoid cyst without cystic wall rupture. Conclusion : Intracordal cysts are very similar to the other mucosal disorders of the vocal cord and it may be misdiagnosed as vocal polyps or nodules, frequently. Therefore careful preoperative examinations for the vocal cord lesions with stroboscopy and other endoscopic instruments are important part of the correct diagnosis. An ideal treatment is enucleation of the cysts without rupture of the cystic wall or injury of the lamina propria. And marsupialization is meaningful to ductal cyst that cannot be enucleated completely.

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The Effect of Voice Therapy Applying Self-Regulation Concepts on Dysphonia Patients (자기 조절 개념을 적용한 음성치료 기법이 발성장애 환자에게 미치는 효과)

  • Lee, Chang-Yoon;An, Soo-Youn;Son, Hee Young
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.1
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    • pp.15-20
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    • 2019
  • Background and Objectives : The goal of this study is to present a strategy for improving the self-regulation (SR) ability and facilitating the change of vocal behavior by applying voice therapy using the SR concept to the patients with vocal cord nodule and muscle tension dysphonia. Materials and Method : The subjects were 80 patients and 80 patients who were diagnosed with muscle tension dysphonia and vocal nodules. As a control group, the results were compared among patients with the same dysphonia without using SR strategies. The concept of SR before voice therapy was explained to the patients, and the treatment was divided into three stages according to the goal of voice therapy. The treatment stages consist of 1) skill acquisition, 2) habit formation, and 3) habit changes. voice therapy was performed by applying SR strategies such as goal implementation intentions and a less routine behavior. Patient's dropout rates were measured to compare the adherence of voice therapy. Results : Significant improvement was seen in all groups receiving voice therapy. However, in the group using the SR strategy, the voice analysis results showed a relatively low dropout rate of voice therapy. In the generalization confirmation stage, patients who applied SR concept showed better results. SR strategy did no longer be necessary to maintain newly adopted vocal behavior. Conclusion : The results of this study show that SR is one of the cognitive factors that can have a significant impact on the outcome of voice therapy, and also has a positive impact on the acquisition and generalization of new skills. A better understanding of SR and the development of therapeutic strategies using it will play an important role in solving voice problems in clinical settings.

The Clinical and Histopathological Study of Laryngeal mass (후두 종양의 임상적 및 병리조직학적 고찰)

  • 김화성;한경수;이준기;정덕희;박재훈
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1981.05a
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    • pp.9.1-10
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    • 1981
  • The clinical study of 183 cases of laryngeal mass was observed and 88 cases of vocal nodule and polyp which is confirmed histopathologically, were clinically classified into 30 cases of vocal nodule, 48 cases of localized vocal polyp, 10 cases of diffuse vocal polyp, and the following results of microscopic examination were obtained. I. The clinical study of laryngeal mass 1. Among total cases of 183, vocal nodule is 82(45%) vocal polyp 53(29%) postintubation granuloma 3(1%) laryngeal papilloma 18(10%) tuberculosis 2(1%) cancer 25(14%). 2. The sex ratio of male to female is 3:4 in vocal nodule, 1:1 in vocal polyp, 1:2 in postintubation granuloma, 3:2 in laryngeal papilloma, 11:1 in cancer. 3. The age distribution is third-fourth decade in vocal nodule, fourth-fifth decade in vocal polyp, third decade in postintubation granuloma, second and fifth decade in laryngeal tuberculosis, sixth decade in laryngeal cancer. 4. The distribution of symptoms is 5 month. -1 year in vocal nodule and polyp, less than 1 year in laryngeal papilloma and postintubation granuloma, 1 year-3 year in laryngeal tuberculosis and cancer. 5. The location of the lesion is between the anterior 1/3 and middle 1/3 in vocal nodule and polyp and papilloma, middle 1/3 and posterior 1/3 in postintubation granuloma, and is diffusely spread on the entire vocal cord in laryngeal tuberculosis and cancer. 6. The side of the lesion is bilateral in vocal nodule and papilloma and the ratio of right to left is 5:3 in vocal polyp, 2:1 in postintubation granuloma. 7. The size is 1~2mm(67%) in vocal nodule, 3~5mm(42%) in vocal polyp, 6~10mm (67%) in postintubation granuloma, 1~2mm (39%) in papilloma, more than 10mm in tuberculosis and cancer. 8. Among the symptoms, the hoarseness is in more than 90% of disease entity, the sore-throat in tuberculosis and cancer, the dyspnea in postintubation granuloma and papilloma and tuberculosis and cancer. 9. In the past history, certain relationship with smoking is noted in cancer (40%) and tuberculosis(50%) and the history of frequent attack of URI is in papilloma(33%). 10. In occupation, certain statistical significance was not noted. II. The histopathological study of vocal nodule and polyp. 1. Most polyps and nodules were covered with stratified squamous epithelium, but focal hyperkeratosis, parakeratosis, acanthosis and atrophy were rather frequently observed. Hyperkeratosis and acanthosis was most frequently seen.

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A Phonetic Analysis of Yodel Singing by the Electroglottographic(EGG) Measurement (요들송에 대한 전기성문파형검사(EGG)를 이용한 발성학적 접근)

  • Suh, D.;Choi, H.S.
    • Speech Sciences
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    • v.7 no.2
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    • pp.113-126
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    • 2000
  • A comparative phonetic analysis of Yodel singing and Belcanto singing by the electroglottographic(EGG) measurement was done in three singers. One professional tenor singer(SDI) who is also well trained in Yodel singing, another yodler(KWS) who is not so trained in Belcanto singing, and the other training tenor singer(CSK) who is not well trained both yodel and Belcanto singing. Closed quotient(CQ), speed quotient(SQ) and fundamental frequency (F0) at the initial modal part(I) , middle falsetto part(M), and final modal part(F) of the same phrase were measured by EGG machine and program(Kay model 4338). In the middle part, not only CQ but also SQ of the Yodel singing were much smaller than that of Belcanto singing in all three singers. However, accuracy of parameters in Belcanto singing of the yodler(KWS) and both Yodel singing and Belcanto singing of the training singer(CSK) were inferior to that of trained tenor singer(SDI). Possible advantages of utilizing Yodel singing training under the guidance of feedback control by the EGG for hyperfunctional voice disorders such as vocal nodules were discussed.

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Comparison of Acoustic Parameters According to the Section of Analysis in Sustained Vowel Phonation (모음연장 음성 샘플의 분석 구간에 따른 음향학적 파라미터 비교)

  • Shin, Yu-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.269-274
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    • 2017
  • This study aimed to investigate the acoustic differences that occur in diverse sections of sustained vowel phonation, which is often used in an objective speech analysis of voice disorder patients. The subjects included 17 voice disorder patients (vocal nodules) and 12 normal individuals without any voice disorder. The participants' sustained vowel phonation of /a/ was divided into onset, middle, and offset, and the jitter, shimmer, and NHR in each section were analyzed using the MDVP(Multi-Dimensional Voice Program). The Friedman test and post hoc analysis were used. In the vocal nodules group, the jitter, shimmer and NHR were significantly higher in the off section of sustained vowel phonation than in the middle section, and there were no significant differences between the beginning and middle sections. In contrast, in the group of normal individuals, there were no significant differences between any of the sections. The values of the acoustic parameters according to the section of analysis in the sustained vowel phonation are different and the vocal in the end section is significantly more unstable than that in the middle section. The results of this study will be useful for selecting the sections to be analyzed in sustained vowel phonation and interpreting the results of the analysis.

A Case of Parahilar Lymph Node Enlargement (폐문부의 림프절 종대 1예)

  • Lee, Hee Jung;Son, Ji Woong;Choi, Eugene;Lee, Won Young
    • Tuberculosis and Respiratory Diseases
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    • v.59 no.2
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    • pp.209-212
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    • 2005
  • Sarcoidosis, a multisystemic granulomatous disorder of unknown causes, which presents with bilateral hilar adenopathy, pulmonary infiltration, and cutaneous, ocular, bones, and nervous and reticuloendothelial systems involvement, commonly involves young adults of both sexes. Herein, the case of a 70-year-old male, with progressive hoarseness of two weeks' duration and mild dyspnea, is reported. A fiberoptic bronchoscopy, performed to investigate the hoarseness, revealed paralysis of the left vocal cord, but with no other local abnormality. Two nodules, as pathologic findings, showed noncaseating epithelioid cell granulomas. We note a rare case of sarcoidosis, with vocal cord palsy, in Korea.

A Clinical study on Two Hoarse Patients (소음인(少陰人) 음아(音啞) 환자(患者) 2례(例)에 대한 증례보고(症例報告))

  • Kim, Seok-Woo;Song, Jeong-Mo;Shin, Dong-Yoon
    • Journal of Sasang Constitutional Medicine
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    • v.17 no.1
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    • pp.142-145
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    • 2005
  • 1. Objectives Hoarseness is most common symptoms of URI. Acute laryngitis, chronic laryngitis, vocal nodules, laryngeal cancer can be the cause of hoarseness, but laryngitis is most common cause. this hoarseness is called as 'Um-a' in Korean medicine and other disease, 'Um-a' can be treated by Sasang constitutional medical diagnosis and treatment. 2. Methods There is two case-reports of the patients who were hoarse and they were treated with Sasang constitutional medicine, Samgyepalmul-tang. 3. Results The patients had shown remarkable clinical effects, when Sasang constitutional medical treatment was practiced. 4. Conclusions Thus we report the healing process and result of this two hoarse patients.

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Transoral $CO_2$ Laser Microsurgery for Laryngeal Lesions (후두질환에서 경구강 $CO_2$ 레이저 미세수술)

  • Lee, Sang-Joon;Chung, Phil-Sang
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.21 no.2
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    • pp.112-120
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    • 2010
  • Transoral $CO_2$ laser microsurgery has been widely used for various laryngeal diseases. Laser cordectomy for the management of early laryngeal carcinoma has advantages with regards to oncologic results, preservation of laryngeal functions, morbidity and cost in comparison to those of open surgery or radiation therapy. $CO_2$ laser is also applicable to benign vocal fold lesions such as nodules, polyps, cysts, reinke's edema, granulomas, papillomas, hemangiomas and glottis webs. $CO_2$ laser is suitable for microsurgery because it has small focus size and hemostatic effect. We should also recognize the risks of $CO_2$ laser for safe use.

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Clinical Characeristics of Intracordal Cysts (성대낭종의 임상적 특성)

  • Hong, Ki-Hwan;Park, Jung-Hoon;Kim, Won;Kim, Chang-Hyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.10 no.2
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    • pp.164-169
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    • 1999
  • Background and Objectives : The intracordal cysts are more increasingly diagnosed and treated due to advanced laryngeal stroboscopy and laryngeal microsurgical technique. The intracordal cysts are frequently misdiagnosed as vocal polyp or nodule The purpose of this study is to evaluate clinical features of intracordal cysts. Materials and Methods : In the present series, 83 cases of the intracordal cysts treated with laryngeal microsurgery are reported. The intracordal cysts are diagnosed preoperatively with indirect laryngoscopy, laryngeal endoscopy, laryngeal stroboscopy and confirmed with laryngeal microsurgical findings and biopsies. Results : Intracordal cysts are 83 of 1900 patients treated with laryngeal microsurgery(4.4%)-ductal cysts are 56 cases and epidermoid cysts are 27 cases. Intracordal cysts are more frequent in women, forties and the frequent site is an anterior third of the true vocal cord. With the indirect laryngoscopic examination, the ductal cysts are frequently misdiagnosed as vocal polyps or nodules but the epidermoid cysts are relatively easily diagnosed. The etiologic factors of the intracordal cysts are suspected as voice abuse and upper respiratory infection. The degree of postoperative voice satisfaction is similar to that of the vocal polyps. Conclusion : Intracordal cysts are frequently misdiagnosed as polyps or nodules, therefore preoperative stroboscopic findings and laryngeal microsurgical findings is important. An ideal treatment is to enucleate the cysts avoiding rupture of cyst and injury of lamina propria of the vocal cord.

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Thyroplasty for the Restoration of a Normal Voice (음성개선을 위한 갑상연골성형술)

  • 김기령;김광문;정명현;이원상;정승규
    • 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.

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