• Journal of Chest Surgery
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• v.18 no.4
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• pp.812-816
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• 1985

In the past several years the popularity of the motor cycle has produced an increasing incidence of the injuries to the larynx and trachea. Most of all on accidents come to death and survivors to the hospital are rare. Early diagnosis and to keep air way are necessary to initiate proper treatment in injury of upper air way. Meticulous apposition of mucous membrane and reconstitution of laryngeal skeleton are important. We experienced a rare case of 26 year old men with cricothyroidal transection after trauma. On Oct. 17, 1985, the patient struck his neck on baggage frame of truck when dropping from his motor cycle on sudden stop. Emergency tracheal intubation on distal segment of trachea was accomplished by otolaryngologist in a local clinic. He was transferred to our hospital. Exploration 2 hours later revealed complete separation of cricoid cartilage from thyroid cartilage. The recurrent laryngeal nerve could not be identified. Anastomosis of thyroid and cricoid was accomplished and Portex endotracheal tube was inserted as splint for 10 days. No stenosis developed. The air way appeared adequate for moderate physical activity though paramedian fixation of vocal cord paralysis. Postoperative follow-up course has been good after he discharged on POD 14 days.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.28 no.2
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• pp.71-78
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• 2017

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.33 no.3
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• pp.172-178
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• 2022

Background and Objectives Injection laryngoplasty is a common method for treatment of unilateral vocal fold paralysis. Unilateral vocal fold paralysis has various causes, including idiopathic, infection, stroke, neurologic condition, surgery and nerve invasion by cancer. To the knowledge of the authors, there was no study on the relationship between the causes of vocal cord paralysis and the outcome of injection laryngoplasty. Therefore, we tried to investigate the difference in the outcomes of injection laryngoplasty between vocal cord paralysis after surgery group and nerve invasion by cancer group. Materials and Method A retrospective analysis was performed for 24 patients who underwent vocal cord injection due to unilateral vocal cord paralysis caused by surgery or nerve invasion by cancer. The objective quality of the voice was assessed by acoustic voice analysis with the Multi-Dimensional Voice Program. Results Both group showed an improvement of fundamental frequemcy (F0), jitter percent, shimmer (percent), and noise to hearmonic ratio (NHR) after injection laryngoplasty. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of F0, shimmer percent and NHR than the vocal cord paralysis due to surgery group, but there was not statistically significant. Conclusion Our study did not show a statistically significant difference in outcome between vocal cord paralysis due to cancer invasion group and surgery group, but statistically tendency was suggested. The vocal cord paralysis due to nerve invasion group showed more improvement in both the mean and median value of acoustic voice analysis than surgery group.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.15 no.1
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• pp.43-47
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• 2004

When a person was suffered from vocal cord paralysis or glottic insufficiency, injection materials (e.g Teflon, Bovine collagen, Autologous fat & tendon, Gelfoam) into the vocal cord have been widely used. But each injection material has some disadvantage. We introduce the Restylane which is composed of a hyaluronic acid, artificially producted. It has advantage of rate foreign body reaction, proper endurance, easy to injection. The patient was 55-year-old woman who showed left vacal cord paralysis after pneumonectomy due to aspergillosis, taken the type I thyroplasty and arytenoid adduction. The middle portion of left vocal cord has some atropic mucosal change, slight chink was noted. The restylane injection into vocal cord was done with suspension laryngoscopy under general anesthesia. In the 3 month follow-up after Restylane injection, the quality of voice has been better progressively. We report a case of Restylane injection as a new method for the improvement of quality of voice.

• 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

• Proceedings of the KOR-BRONCHOESO Conference
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• 1977.06a
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• pp.6.2-7
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• 1977

Hoarseness, caused by any condition that interfers with normal phonatory function of larynx, is the most important symtom of the laryngeal disease. The air pollution is the serious social problom today due to irritation of the respiratory mucosa and secondary respiratory disease. It is significant to study whether, in resent years, the patients with complant of hoarseness has being increased or decreased, compare to past years. The authors report a statistical analysis on 400 cases with chief complain of horseness at the Department of Otolaryngology, Hanil Hospital during past 7 years from Jan. I, 1970 to Dec. 31, 1976. The results were as follows; 1) Among total out patients of 14, 731 who visited to the department of otolaryngology, the patients with hoarseness numbered to 400(2.7%). 2) Among total of 400 cases, male were 211 and female were 189. The incidence was slightly higher in male than female with ratio 1.1 to 1 in sex distribution. 3) The uderlying diseases causing hoarseness in order of frequency were Acute Laryngitis (158 cases, 39.5%), Chronic Laryngitis (103 cases, 27.3 %), Vccal Nodule (37 cases, 9.3%), Vocal cord paralysis (34 cases, 8.5%), Laryngeal Polyp (32 cases, 8%), Laryngeal Ca. (13 cases, 3.5%), and Laryngeal Tbc. (9 cases, 2.3%). Particulary, Laryngeal Ca., Laryngeal polyp and Laryngeal Papilloma were extremely high in male but the remainings were equally distributed in sex group distribution. 4) The highest incidence occurred in 3rd decade (113 cases, 28.5%), the next 4th and 2nd decade in the age group distribution. Acute and Chronic Laryngitis were widely distributed in age group distribution but the highest incidence was noted between 3rd and 4th decade (145 cases, 55.5%). The highest incidence was 3rd decade in Laryngeal polyp, 3rd and 4th decade in Vocal Nodule, 4th and 5th decade in Laryngeal Tbc. and Vocal cord paralysis and 5th decade in Laryngeal Ca. 5) The underlying disease causing hoarsness were evenly occurred in monthly distribution but relatively high incidence was observed between April and June (35.5%) compared to winter. 6) In durational distribution, the highest incidence was within 10 days (26%) from onset to consultation. 317 cases (80%) were visited to the clinic within 1 year.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.107-111
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• 2019

Background and Objectives Idiopathic unilateral vocal fold paralysis (IVFP) is believed to be due to inflammation and edema of the recurrent laryngeal nerve caused by viral diseases such as upper respiratory tract infections. Corticosteroid has a potent anti-inflammatory action which should minimize nerve damage. The purpose of this study was to investigate the effect of oral steroid therapy on IVFP. Materials and Method Study was performed for the IVFP patient from January 2012 to August 2017. Patient's dermography, direction and location of paralyzed vocal cords, history of hypertension, diabetes, cerebrovascular disease, and other underlying disease, smoking history, alcohol consumption and upper respiratory tract infection, and symptoms were investigated. Treatment was divided into three groups: the observation group, low-dose group, and high-dose group, and the recovery rate and time of vocal cord paralysis were analyzed in each group. Results Thirty-seven patients were enrolled in this study. There was no relationship between oral steroid use, dosage and recovery of vocal cord paralysis. Oral steroids showed a rapid recovery of vocal cord paralysis, but there was no statistically significant difference in the time of recovery of vocal palsy with or without steroids (p=0.673). In addition, there was no statistically significant difference in recovery rate between the period to start of treatment, presence of diabetes mellitus, and treatment modality, but the recovery rate was high in the group with upper respiratory tract infection history (p=0.041). Conclusion In IVFP, oral steroid therapy has no significant difference in time and extent of recovery compared to the case of spontaneous recovery.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1987.05a
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• pp.16.2-16
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• 1987

최근 전신마취의 발달로 외과영역에서는 괄목할만한 수술적 진전을 보여 왔으나, 이에 못지 않게 전신마취에 의한 여러 가지 합병증의 보고가 늘고 있다. 특히 이비인후과영역에서는 술후 뚜렷한 원인없이 사성 및 호흡곤란 등을 호소하는 환자들을 종종 접하게 되며, 추정할 수 있는 유인으로는 대개 후두 및 기관점막의 염증, 후두결절, 후두육아종 등이 대부분이나 때로 매우 희귀하지만 원인 불명의 성대마비로 인한 경우도 있다. 저자는 최근 술전에 전혀 후두증상이 없었던 환자로서 기관내 삽관마취하 이하선 혼합종수술후에 속발한 일측성 반회신경마비례를 경험하였기에 문헌적 고찰과 함께 보고하고자 한다.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.2
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• pp.138-142
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• 2006

Objectives : Vocal cord paralysis(VCP) is a complex disorder which may result from numerous causes. We reviewed and analyzed the trend of clinical characteristics and causes of VCP in Korean patient. Method : A total 197 patients with VCP who visited St.Mary's hospital from March, 2000 to August, 2006 were reviewed retrospectively. They were analyzed according to sex, age, cause of VCP, position of paralyzed vocal fold, treatment methods. Results : The male and female ratio was 1.6 : 1. The unilateral paralyzed vocal fold was fixed at paramedian position in 84% of the cases. The left vocal fold was paralyzed about 2 1/2 times as much as the right vocal fold. Among the causes of VCP 30.9% of the cases were due to postoperative paralysis, and most of those were developed after lung, mediastinal surgery. laryngeal EMG was performed in 47 patients for determines the prognosis and treatment method. In the unilateral VCP, 90 patients were treated with injection laryngoplasty, 21 patients were performed thyroplasty type I. Conclusion : The causes of VCP include various diseases, so, detection of the primary disease is very important, because many fatal diseases are included among the primary diseases, and late detection can cause serious problems. VCP is not only a disease entity in itself, but can be seen as a sign of an underlying disease.

• Journal of Biomedical Engineering Research
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• v.23 no.3
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• pp.197-205
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• 2002

The objectives of this Paper is to implement a diagnostic classifier of differential laryngeal diseases from acoustic signals acquired in a noisy room. For this Purpose, the voice signals of the vowel /a/ were collected from Patients in a soundproof chamber and got mixed with noise. Then, the acoustic Parameters were analyzed, and hierarchical neural networks were applied to the data classification. The classifier had a structure of five-step hierarchical neural networks. The first neural network classified the group into normal and benign or malign laryngeal disease cases. The second network classified the group into normal or benign laryngeal disease cases The following network distinguished polyp. nodule. Palsy from the benign laryngeal cases. Glottic cancer cases were discriminated into T1, T2. T3, T4 by the fourth and fifth networks All the neural networks were based on multilayer perceptron model which classified non-linear Patterns effectively and learned by an error back-propagation algorithm. We chose some acoustic Parameters for classification by investigating the distribution of laryngeal diseases and Pilot classification results of those Parameters derived from MDVP. The classifier was tested by using the chosen parameters to find the optimum ones. Then the networks were improved by including such Pre-Processing steps as linear and z-score transformation. Results showed that 90% of T1, 100% of T2-4 were correctly distinguished. On the other hand. 88.23% of vocal Polyps, 100% of normal cases. vocal nodules. and vocal cord Paralysis were classified from the data collected in a noisy room.