• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.29 no.1
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• pp.30-36
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• 2018

Background and Objectives : The effect of palliative injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients on voice and swallowing function is uncertain and there are few previous studies of its suitability, benefits as a palliative treatment option. The purpose of this study is to confirm the objective results of voice and swallowing function after palliative office-based hyaluronic acid injection laryngoplasty in cancer-related unilateral vocal cord paralysis patients. Materials and Method : 36 patients who had unilateral vocal cord paralysis from non-thyroidal, extralaryngeal neoplasms were included in this study. To evaluate the clinical outcome, we analyzed perceptual GRBAS grading, acoustic analysis, aerodynamic study, Electroglottography (EGG), Voice Handicap Index (VHI-30) about voice function and disability rating scale (DRS), gastric tube dependency, aspiration pneumonia about swallowing function and 36-Item Short Form Survey version 2 (SF-36v2) about quality of life. Results : In GRBAS scale, G (p<0.001), R (p=0.004), B (p=0.001), A (p=0.011), and S (p=0.007) showed significant improvement. Jitter, shimmer, speaking fundamental frequency, maximal phonation time, VHI-30, DRS score, gastric tube dependency, aspiration pneumonia, and SF-36v2 were significantly improved after injection (p=0.016, p=0.011, p=0.045, p=0.005, p<0.001, p<0.001 p=0.003, p<0.001, and p<0.001 respectively). Conclusion : From this study we concluded office-based hyaluronic acid injection can be used as a useful palliative treatment option in cancer-related ill patients with unilateral vocal cord paralysis. Palliative hyaluronic acid injection laryngoplasty avoids the need for tube feeding, thus reducing the risk of aspiration pneumonia. These outcomes are accompanied by significant improvement in voice quality.

• The Journal of Korean Medicine
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• v.35 no.1
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• pp.26-40
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• 2014

Objectives: This study investigated the effect of electroacupuncture on swallow function in stroke patients with dysphagia. The purpose was to determine whether electroacupuncture could improve swallow function and quality of life for patients with dysphagia caused by stroke. A pilot double-blind, randomized controlled trial design was used Methods: A total of 17 stroke patients with dysphagia were recruited to this study, 8 assigned to the swallowing electroacupuncture (SE) group and 9 to the control group. Swallowing electroacupuncture was assessed for 5 Hz electrical or sham stimulation for 20 min duration 3 times a week. Outcome measurements were DOSS, 14-item questionnaire from the SWAL-QOL, NIHSS and MBI. Assessment was carried out for baseline, 2 weeks and 4 weeks Results: In the 2 weeks follow up data, the study group showed significant difference in DOSS and SWAL-QOL compared with the baseline. The study group also showed significant difference in DOSS and SWAL-QOL compared with the control group. Similarly in the 4 weeks follow up data, the study group showed improvement tendency in DOSS and SWAL-QOL compared with baseline and also with the control. The NIHSS and MBI scores returned no significant differences. The swallowing electroacupuncture was well tolerated in all cases with no serious adverse effects. Conclusions: The findings from the pilot study indicated that electroacupuncture has significant effects on improvement in swallowing function and quality of life. With both inpatients and outpatients, further larger and longer-term follow-up study is needed to confirm this suggestion.

• The Journal of Advanced Prosthodontics
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• v.7 no.1
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• pp.8-14
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• 2015

PURPOSE. To assess function by identifying changes in swallowing and masticatory performance in maxillary obturator prosthesis wearers. MATERIALS AND METHODS. Sixty subjects were recruited for the study, of which 20 were obturator wearers, 20 were completely dentulous and 20 had removable partial/complete dentures with similar Eichner's Index. Swallowing ability was evaluated with and without obturator using the "Water Drinking Test"; Masticatory performance was evaluated with the Sieve test; and maximum occlusal force was recorded with the help of a digital bite sensor. The data was analyzed using the Statistical Package for Social Science version 15.0 with a confidence level at 95%. RESULTS. Profile, behavior of drinking and time taken to drink were significantly improved (P<.001) in subjects after wearing obturator. Masticatory performance was not significantly different (P=.252) in obturator wearer when compared with dentulous or removable partial/complete denture wearer, but significantly (P<.001) high inter group difference in maximum occlusal force existed. Correlation between masticatory performance and maximum occlusal force was not significant (P=.124). CONCLUSION. Swallowing ability was significantly improved after wearing obturator but masticatory performance was not significantly different from those having similar occlusal support zone in their dentition.

• The Korean Journal of Pain
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• v.11 no.1
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• pp.119-123
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• 1998

It is well known that many patients with trigeminal neuralgia suffer from electric shock-like stabbing pains. The pain can be triggered by nonnoxious stimuli such as touching of the face, chewing, talking or swallowing. This 62 year old woman was urgently admitted to the internal medicine department due to abdominal distention and severe general weakness. She has suffered characteristic violent pain triggered by chewing and swallowing for little over 4 years. This resulted in poor oral feeding for prolonged period which left her severely debilitated. The large amount of ascites that developed 20 days before admission and extreme emaciation forced her to bed rest. She also suffered from Herpes Zoster. After medical treatment to improve liver function and severe pain was persisted, the patient was referred to our department for control of pain. We performed right mandibular block with 1% dibucaine 0.4 ml and the effect was excellent. After the pain had subsided, patient was able to take meals more comfortably and improved liver function returned.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.1
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• pp.52-55
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• 2011

Hyperfunction of the upper esophageal sphincter (UES) can cause severe dysphagia. This condition referred as cricopharyngeal dysphagia may occur after head and neck surgery due to altered muscle spasm and stenosis of the pharyngo-esophageal segment. Among various treatment options available, Botulinum toxin A (Botox) injection offers a nonsurgical treatment which is useful especially for debilitated patients, and there has been a recent increase in the clinical use of Botox by otolaryngologists for managing such conditions. A 55-year-old male with base of tongue (BOT) cancer suffered from severe dysphagia after total glossectomy and neck dissection treatment. Videofluoroscopic swallow study (VFSS) and flexible endoscopic evaluation of swallowing (FEES) showed inability to pass food through the UES due to cricopharyngeal spasm. After injection of 10 U of Bot ox into each cricopharyngeus muscles (total 20 U) via EMG-guided percutaneous injection, swallowing function had improved and oral nutrition was possible, with food passing through the UES visualized on VFSS and FEES.

• 재활복지
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• v.22 no.1
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• pp.169-194
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• 2018

The aim of this study is to examine changes in swallowing function and quality of life with therapeutic singing-based music therapy for patients with dysphagia. The music therapy program was based on the previous study (Kim, 2010), and designed to improve breathing, phonation, and swallowing functions focusing on laryngeal elevation. Three patients with dysphagia participated in this study and each participant received a total of 11 or 12 individual music therapy sessions and each session was conducted for 30 minutes. In this study, three kinds of measurements were used. First, the measures of maximum phonation time (MPT), fundamental frequency, average intensity, jitter, shimmer, noise to harmonics ratio (NHR) by Praat test, second, laryngeal-diadochokinesis (L-DDK) to investigate laryngeal elevation, and last, the Swallowing-Quality of Life (SWAL-QOL) was measured. These cases have shown improved breathing, phonation, swallowing function, and the scores of SWAL-QOL in all of the patients. It suggests that this music therapy intervention was effective on laryngeal elevation, and the music intervention with therapeutic singing can be effectively implemented in further research for patients with dysphagia.

• Therapeutic Science for Rehabilitation
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• v.11 no.4
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• pp.69-83
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• 2022

Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.378-388
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• 2023

Background: With increasing interest in health in old age, aspects of oral aging are being considered. The Korean Academy of Geriatric Dentistry recently proposed the diagnostic criteria for oral frailty in older adults in Korea. This study aimed to conduct a cross-sectional survey of factors related to oral frailty among community-dwelling older adults and identify differences in oral frailty status according to age and sex. Methods: Among 217 older adults aged ≥60 years who visited a senior center in Wonju, 206 completed all tests for oral frailty. Among them, data from those with a Korean Version of the Modified Barthel Index score ≥90 were used in the final analysis. After evaluating oral frailty diagnostic factors such as chewing ability, occlusal force, tongue pressure, oral dryness, oral cleanliness, and swallowing function, oral hypofunction was determined according to the oral frailty diagnostic criteria. Subsequently, the evaluation results were compared based on sex and age. Results: Significant differences in chewing ability, maximum occlusal pressure, and maximum tongue pressure were observed between sexes. However, these differences did not affect oral frailty diagnosis. All diagnostic factors of oral frailty, except for the risk of oral dryness and swallowing dysfunction, showed significant differences with age. However, no significant difference was observed in the prevalence of oral frailty. Additionally, this study found no relationship between sex and oral frailty factors using the oral frailty diagnostic criteria. However, it also found that age plays a significant role as an oral frailty diagnostic indicator, in addition to oral dryness and swallowing function. Conclusion: Sex and age did not affect oral frailty diagnosis. However, patients' chewing ability, occlusal force, and tongue pressure were affected by sex and age. Therefore, sex and age should be considered when diagnosing and intervening in oral frailty in the future.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.255-260
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• 2008

Purpose: Tongue cancer is the most common malignant tumor of the oral cavity and the ultimate goal in treatment of the cancer is not only complete excision and meticulous closure of the wound, but also, reconstruction of a demensional and functional tongue. Our study focuses on various factors, such as defect size, extent of tumor, age, application of mandibulectomy or radiotherapy, and their influences on postoperative speech and swallowing function. Methods: Our study was based on 59 patients who underwent tongue cancer operation and reconstruction of the tongue. Speech and swallowing were evaluated according to categories documented by Sultan and Teichgraeber. Patients were classified into 3 groups as partial glossectomy, hemiglossectomy and total glossectomy groups for evaluation. The average age of the patients were 51, and the mean follow-up period was 4 years 2 months. Results: The partial glossectomy group showed statistically relevant results for speech articulation and swallowing abilities compared to the total glossectomy group. In cases of defects involving the mouth floor, the group showed decreased results compared to the group without mouth floor involvement. Increased age showed decreased postoperative results with statistical significance, while mandibulectomy and radiotherapy revealed no statistically significant data. Analysis according to TNM staging resulted in decreased functional result with advanced staging without statistical significance. Conclusion: To summarize the factors influencing the functional outcome in tongue reconstruction, younger patients and early stage cancer with minimal surgical extent revealed more satisfying results while mandibulectomy and radiation did not have influence on our analysis. Addition of various influencing factors and studies with longer follow up periods on our patient groups may provide effective data for more satisfying functional outcomes in the future.

• Korean Journal of Bronchoesophagology
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• v.16 no.1
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• pp.27-32
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• 2010

Organ preservation surgery and minimally invasive surgery have been developed during the past 20 years with major focus on transoral laser surgery, endoscopic surgery, and robotic surgery. Two major robotic surgeries in head and neck area are transoral robotic surgery (TORS) and robotic thyroidectomy. Transoral robotic surgery is a safe and efficacious method of surgical treatment of oropharyngeal. hypopharyngeal and laryngeal neoplasm. Advantages of the technique include adequate ability to visualize and manipulate lesions with two hands. TORS can provide magnified three dimensional views and overcome the limitation resulting from the "line of sight" which hinders transoral laser procedure. The swallowing function following transoral robotic surgery show superior and patients were able to retain or rapidly regain swallowing function in the majority of cases. Recently, robotic thyroidectomy has also been developed to overcome the [imitation of endoscopic thyroidectomy. Robotic thyroidectomy by a gasless unilateral axillo-breast or axillary approach using a da Vinci S Surgical Robot is a feasible and cosmetically excellent procedure. It can be a promising alternative to endoscopic thyroidectomy or conventional open thyroidectomy.