• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.9 no.1
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• pp.79-85
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• 1998

Changes in the human voice occur between infancy and old age and reflect a myriad of biological changes that influence the size, shape, and physical properties of the larynx. The human larynx is located near the base of the neck and attached inferiorly to the trachea and opens superiorly into the pharynx. The larynx by the third month of fetal life has the same features recognizable at birth. The fundamental frequency of vocal fold vibration generally becomes higher in early age, lower in middle age, and higher in old age. These decreases in Fo undoubtedly result from a combination of factors, consisting of modest increase in length and mass of the muscle and connective tissues of the vocal fold. But the level of the larynx in the neck may be closely connected with Fo directly, high larynx in related with high pitch and low larynx with low pitch. The purpose of this study is to determine the developmental level difference from child to adult larynx using conventional radiography, and the change of speaking fundamental frequency from second decade to sixth decade.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.1
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• pp.49-53
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• 2020

Cri-du-chat syndrome (CdCS) is caused by the deletion of the short arm of chromosome 5. Most patients with CdCS develop intellectual disabilities. Therefore, they have poor oral hygiene and a high caries index. However, treating such patients is not an easy task, because of the difficulty in communication. General anesthesia may be a useful option in adult patients with CdCS and intellectual disability. General anesthesia should be administered very carefully, owing to the presence of comorbid diseases, which may need airway management. Infants with CdCS need general anesthesia if they have a concomitant cardiac anomaly. Intubation is reportedly difficult for such patients was, owing to the structural and functional abnormalities in the larynx and vocal cords. The purpose of this study was to report a case of difficult intubation while inducing general anesthesia in a patient with CdCS during dental treatment, due to a narrow larynx and trachea.

• Medical Lasers
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• v.9 no.2
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• pp.126-133
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• 2020

Recurrent respiratory papillomatosis (RRP) is a benign tumor that occurs in the respiratory tract, especially in the larynx. The etiology of RRP is human papillomavirus (HPV). According to the age of occurrence, RRP is divided into childhood-onset and adult-onset types. Generally, childhood-onset RRP shows a high recurrence rate and diffuse involvement in the respiratory tract. Adult-onset RRP is more localized and appears more frequently as a solitary lesion. It may be the result of sexual transmission or the proliferation of latent HPV infections. At present, the treatment of choice for RRP is CO₂ laser ablation. In addition, pulse dye laser or KTP (KTiOPO: potassium-titanyl-phosphate) lasers are also used. Non-surgical adjuvant therapies can be applied in cases requiring repetitive surgery or with diffuse extensions. This review will introduce the clinical features of RRP and various treatment options including lasers.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.52-54
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• 2004

Hemangioma of the larynx is generally classified into adult and infantile form. More common infantile form usually arises on subglottic portiion and may cause respiratory distress. Adult form is rare and arises on vocal cord or above. Vocal cord hemangioma was rarely reported in the medical literature. Since Kimmelman et al reported vocal hemangioma in 1979 first, there are four cases of vocal hemangioma reported in medical literature. Recently, we experienced a case of vocal cord hemangioma and successfully removed it with micro-laryngeal surgery. Hence we report this case with review of literatures.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.2
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• pp.104-108
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• 2021

The etiology of laryngeal hemangioma is unclear, and it is classified into infant and adult types. The former is capillary hemangioma and relatively common, the latter is cavernous type and very rare. The adult laryngeal hemangioma mainly occurs in supraglottis and glottis. A 75-year-old man came to our clinic with a voice change that started four months ago. The laryngoscopic finding showed that the surface of oval-shaped mass is covered with turbid exudates. We performed the laryngeal microsurgery with CO₂ laser. The mass was pathologically proven as cavernous hemangioma. We report a very rare and didactic case with review of relevant literature.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.14 no.2
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• pp.83-87
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• 2003

Background and Objectives : Sphincteric function of the larynx, essential to lower airway protection, is most efficiently achieved through strong reflex adduction by both vocal cords. We hypothesize that central facilitation is an essential component of a bilateral adductor reflex and that its disturbance could result in weakened sphincteric closure. Materials and Method : Seven adult 20kg dogs underwent evoked response laryngeal electromyoraphy under 0.5 to 1.0 MAC isoflurane anesthesia. The internal branch of superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes and recording electrodes were positioned in the ipsilateral and contralateral thyroaryteonoid muscles. Results : Consistent threshold responses were obtained ipsilaterally under all anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels approached 1.0 MAC. Additionally, at 0.5 MAC, late responses (R2) were detected in one animal. Conclusion : Alteration of central facilitation by deepening anesthesia abolishes the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may improve the prevention of aspiration in patients emerging from prolonged sedation or under heavy psychotropic control.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.8 no.1
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• pp.44-48
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• 1997

Anatomic and physiological changes of the larynx with advancing age result in morphologic changes of the vocal fold and reduced control of the phonatory mechanism in elderly individuals and are reflected in increased unstability of fundamental frequency (Fo). The purpose of this study is to increase current understanding of acoustic and stroboscopic characteristics of normal elderly persons voices. First, phonated /a/ vowel productions by 40 normal adults (20 to 40 years, 20 men and 20 women) and 40 normal elderly persons (60 to 80 years,20 men and 20 women) were analyzed, using CSL (model 4300B) acoustic analysis software, to obtain acoustic measures related to fundamental frequency stability nd vocal resonance characteristics. Second, stroboscopic images of the vocal fold behavior in all subjects were analyzed by experienced specialists. In the men, fundamental frequency variation (vFe) (p＜0.01), jitter. (p＜0.05), and shimmer (p＜0.05) for the older group were significantly higher than the value for the adult group. In the stroboscopic findings, edema of vocal fold had a significant finding in aged men (15%). In the women, vFo (p＜0.05), jitter (p＜0.05), and noise to harmonic ratio (NHR) (p＜0.05) for the older group were significantly higher than the value for e adult group and first formant frequency (F1) (p＜0.01) and second formant frequency (F2) (p＜0.01) for. the older group were significantly lower than the value for the adult group. In the stroboscopic findings, vocal fold atrophy had a significant finding in aged women (25%). Frequency stability, as reflected by vFo, jitter, shimmer, and NHR, decreases with advancing age in men and women and spectral analysis of phonated /a/ vowel productions reveals the lowering of the frequency of F1 and second F2 with advancing age, especially in aged women. Change in the mass of vocal folds, due to atrophy or edema, is considered to be the greatest factor in these acoustic changes.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.30 no.5
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• pp.437-446
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• 2008

Electroglottography (EGG) is a simple and non-invasive technique for analyzing the vibratory patterns of the vocal folds by detecting impedance changes across the larynx. An abnormal electroglottogram is shown in patients who have a dysphagia associated with neuromuscular disorder. Electroglottography offers reliable informations for diagnosis of swallowing disorder and gives quantitative datas. The purpose of this study is to provide the normal value of electroglottography in normal adults. We took electroglottograms of 80 adults who have no problem in swallowing and utterance. EGG data were analyzed to find out the value of Pitch, Jitter and Closed quotient with a commercially available software. There were significant differences between a usual voice and loud voice in 3 measures on the EGG signalmean pitch, Avg. jitter, mean quotient. To get a proper electroglottography, phonation of a usual voice was better than a loud voice. Four measurements- S.D pitch, Avg. Jitter, Mean closed quotient, S.D closed quotient- were independent of sex for adult. Three measurements- Mean pitch, S.D pitch, Mean closed quotient - were independent of age for adult aged twenties to fifties. The Avg. Jitter of twenties appeared to be lower than those of forties and fifties. The S.D closed quotient of twenties appeared to be lower than those of thirties, forties and fifties.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1982.05a
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• pp.9.1-9
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• 1982

The authors have measured various dimensions of the larynx of twenty adult cadavers. (male; 13, female; 7) The result were as follows, 1) Transverse diameter between the greater horns of the hyoid bone; M.52.58mm, F.43.07mm. 2) Transverse diameter between the lesser horns of the hyoid bone; M.36.20mm, F.30.20mm. 3) Transverse diameter of the thyroid cartilage; M.50.58mm, F.42.58mm. 4) Transverse diameter of the cricoid cartlage; M.30.14mm, F.26.94mm. 5) Distance from the lower margin of the hyoid bone to the thyroid notch; M.12.83mm, F.10.92mm. 6) Distance from the lower margin of the thyroid cartilage to the lower margin of the cricoid cartilage; M.16.40mm, F.10.26mm. 7) Distance from the upper margin of the thyroid cartilage to the lower margin of the cricoid cartilage; M.34.65mm, F.34.61mm. 8) Anteroposterior diameter of the cricoid cartilage; M.25.32mm, F.20.01mm. 9) Transverse diameter of the epiglottis; M.29.32mm, F.22.08mm. 10) Vertical diameter of the epiglottis; M.35.90mm, F.27.90mm. 11) Transverse diameter between the cuneiform tubercles; M.17.69mm, F.13.52mm. 12) Length of the vocal fold; M.11.61mm, F.10.40mm. 13) Transvers diameter of the vocal fold; M.18.62mm, F.18.27mm. 14) Distance from the upper margin of the epiglottis to the vocal fold; M.42.45mm, F.34.52mm. 15) Anteroposterior length of the vocal fold; M.19.25mm, F.10.70mm.

• Korean Journal of Bronchoesophagology
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• v.16 no.2
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• pp.145-148
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• 2010

Background: Laryngeal papillomatosis, which is cased by human papillomavirus, is the most common benign neoplasm of the larynx. However, the prognosis of this disease remains really unpredictable. The aim of this paper is to determine whether any clinical features at the time of diagnosis could predict its course. Material and Method: Eighty-six patients treated at our institution during the last 20 years were analyzed retrospectively. All patients had microsurgery under general anesthesia. All patients' follow-up period was more than 1 year. We divided the patients into 1) Juvenile versus adult group based on their age 20, 2) single surgical method with laser versus dual surgical method with laser and microdebrider group, and 3) single subsite versus multiple subsites group. And we compared the therapeutic outcome. Results: The recurrence rate was 100% (15 patients) in the JP group and 56% (40 patients) in the AP group. Juvenile versus adult group was the only independent prognostic factor by univariate, and multivariate analysis. Microdebrider resection technique and multiple subsites were not associated with treatment result. Time period from the first surgery to recurrence detection was different statistically only for the age group. The number of surgery in the JP group ranged from 1 to 31 (mean 8.8). In the AP group the number of surgery ranged from 1 to 25 (mean 3.7). It was statistically different. Conclusion: Prognosis for the laryngeal papillomatosis remains unpredictable. Only patients' age was the only independent prognostic factor.