• Journal of Chest Surgery
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• v.23 no.3
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• pp.522-526
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• 1990

We have experienced 2 cases vocal cord paralysis after open heart surgery. One was a postoperatively developed right unilateral vocal cord paralysis after prosthetic mitral valve replacement with tricuspid valve annuloplasty. The other was a postoperative left unilateral vocal cord paralysis after prosthetic aortic and mitral valve replacement with tricuspid annuloplasty. They were intubated for forty-eight and seventy-two hours but after extubation complained of hoarseness, aphonia, anxiety, and ineffective coughing Indirect laryngoscopy performed at about postoperative one week, revealed partial paralysis and decreased mobility of the vocal cord. After active phonation therapy, symptoms were improved gradually and in the follow up indirect laryngoscopy, the vocal cord paralysis was improved. The symptoms were recovered completely at about postoperative one month in both. The cause of vocal cord paralysis after open heart surgery may be any retraction or stretching injury to the recurrent laryngeal nerve, especially right side, during median sternotomy retraction and open heart operation procedures. As a result, avoid of excessive spread of median sternotomy retractor and excessive manipulation and retraction of the heart during open heart procedures will reduce the occurrence of the vocal cord paralysis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.6 no.1
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• pp.27-38
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• 1995

It is well known that unilateral vocal cord paralysis is a sign of a disease and not a disease entity. In an attempt to evalute incidence of unilateral vocal cord paralysis related to varoius causes and to analyze our treatment results, the records of 210 patients seen at the Department of Otorhinolaryngology, Yongdong Severance Hospital during the 10-year period from March 1985 to March 1995 were reviewed. Fifty-three patients(25.2%) of the 210 patients with unilateral vocal cord paralysis had surgery-related causes, and intubations including tracheostomy was the most common etilogy among them. One hundred and fifty seven cases(74.8%) was not related to surgery and, among these most common cause was idiopathic. Spontaneous recovery took place in 17(8%) patients. Phonosurgery including type Ⅰ thyroplasty(n=16) and arytenoid adduction(n=10) and combination of them(n=3) yielded good results except intrafold teflon injection(n=4). These results of our series were compared to other series reported over the past decades.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.11 no.1
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• pp.20-27
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• 2000

To determine what is the change of pre and postoperative voice and image analysis parameters and correlations between them, videostroboscopy was analyzed in each 18 patients with unilateral vocal cord paralyses or vocal polyps before and after the surgery from November, 1996 to April, 1999. The correlation between acoustic and aerodynamic parameters was investigated. The software-Videolink and $\pi$-View(Mediface Co, Seoul, Korea)-was used in a quantitative analysis. In unilateral vocal cord paralysis, the glottic angle is well correlated with maximum phonation time, jitter and shimmer preoperatively. The postoperative glottic angle is also correlated with preoperative maximum phonation time. In patients with the vocal polyp, the chink is postoperatively decreased, but the size of the chink and the polyp is not correlated with pre and postoperative voice analysis parameters. These findings reveal that glottic an and vocal fold angle are good indicators of e postoperative glottic configuration in unilateral vocal cord paralysis. Vocal fold ratio is also a useful indicator that represents the length of vocal folds. We consider that the computerized analysis through videostroboscopy is one of objective diagnostic methods in many voice disorders if we can measure a distance between the telelaryngoscope and vocal folds.

• 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.33 no.2
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• pp.59-63
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• 2022

The laryngeal framework surgery (LFS) is an operation to correct the position and tension of the vocal cords by changing the laryngeal cartilage and muscles. LFS such as type 1 thyroplasty, arytenoid adduction, and arytenopexy is performed to improve the voice of patients with unilateral vocal cord paralysis. It is known that the voice improvement effect of LFS in patients with unilateral vocal cord paralysis is excellent and lasts for a long time. LFS can also be operated under local anesthesia. Complications are not common, however, severe complications like airway obstruction could occur after the operation. Recently, several other attempts to modify the traditional surgical method have been reported. This review is intended to be helpful in understanding the characteristics and changes in laryngeal framework surgery.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.1
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• pp.23-27
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• 2006

Purpose: There are a few case reports on asymmetric vocal cord uptake on FDG-PET in patients with unilateral vocal cord paralysis, which could be a potential pitfall in the interpretation of FDG-PET images. We evaluated the metabolic activity of laryngeal muscles of patients with unilateral vocal cord paralysis in comparison to normal controls during both speech and silence. Methods: Eleven patients with unilateral vocal cord palsy (thyroldectomy=7, lung cancer=1, others=3) and 12 normal controls underwent FDG-PET with usual protocol. They were divided into two groups respectively; one group read books aloud for 20 minutes (phonation group) and the other kept silence (non-phonation groups) after FDG injection. Recent neck CT scan were co-registered with FDG-PET to produce PET-CT fusion images to elaborate small laryngeal muscles. Results: In patients with unilateral vocal cord palsy, contralateral non-paralyzed vocal cord showed hypermetabolism mainly on thyroarytenoid muscle, more intensely with phonation group ($SUV=5.88{\pm}2.65$) than with non-phonation group ($SUV=2.30{\pm}0.39$). Normal control subjects showed hypermetabolism ($3.68{\pm}0.96$) in interarytenoid muscle and symmetric mild hypermetabolism in both lateral cricoarytenoid muscles in only phonation group. Conclusion: FDG-PET with fusion images using CT scan in patients with unilateral vocal cord paralysis showed hypermetabolism of contralateral non-paralyzed thyroarytenoid muscle, suggesting compensatory action during phonation. Phonation durung FDG PET study enhanced FDG uptake on different laryngeal muscles between patients with unilateral vocal cord paralysis and normal subjects.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1993.05a
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• pp.74-74
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• 1993

Unilateral vocal cord paralysis is induced by various causes and its effective treatment has been diversely searched out until now. Currently used treatment modalities are intracordal injection of exogenous materials such as Teflon or Silicone, and thyroplasty and so forth. But, with the above mentioned modalities, it has been not satisfactory to obtain a good postoperative results especially in cases when the glottal incompetence is very severe or the level difference between the vocal cords is large. In such cases, vocal cord adduction can be accomplished by anteromedial traction of the muscular process of paralyzed vocal cord via surgical exposure resulting improvement of voice quality. Recently, authors performed arytenoid adduction in 3 cases of unilateral vocal cord paralysis to obtain a better improvement of voice quality, and experienced satisfiable postoperative results.

• 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.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.112-116
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• 2015

Background and Objectives : Aerodynamic analysis is an examination which provides information regarding various vocalization measures indicating laryngeal efficiency. Voice evaluation using such examination must be capable of distinguishing between normal to abnormal voice. It also observes variables on aerodynamic characteristics by gender in regards to patients of vocal disorders, especially of vocal cord paralysis and vocal polyp, and compares the conditions before and after surgery. This paper therefore, seeks to build a framework for establishing standard levels of aerodynamical characteristic on vocal disorders. Subjects and Methods : The study was intended for a total number of 20 patients with vocal polyp or unilateral vocal cord paralysis. Those with the vocal polyp underwent laryngomycroscopy surgery and the vocal cord paralysis, vocal fold injection using Restylane. Aerodynamic analysis fulfilled the Maximum sustained Phonation (MXPH) and Voicing Efficiency (VOEF) by using PAS Model 6600 (KayPENTAX, USA). Results : In MXPH, increase in PHOT were evident with vocal polyp after surgery. As for patients with vocal cord paralysis, MAXDB, MEADB, DHODB, PHOT all have increased and MEAP, PEF, MEAF decreased after surgery. In VOEF, patients with vocal cord paralysis who underwent surgery showed increase in MAXDB, MEADB, DHODB, FET100, ARES, but decreases in PEF, TARF. Conclusion : Overall, it can be concluded that patients with the vocal polyp and vocal cord paralysis seemed to get closer to the normal values after than before surgery in majority of measures. This confirms that the function of their vocal cord has improved nearly to normality through operations.

• 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