• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.22 no.2
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• pp.119-125
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• 2011

Background and Objectives : Temporary or permanent vocal paralysis can be occurred after head and neck surgery such as thyroid cancer, esophageal resection, and chest operation including lung parenchymal resection, due to a vagus or recurrent laryngeal nerve injury. The authors aimed to determine the clinical efficacy of using Calcium-Hydroxyapatite (CaHA) for permanent unilateral vocal cord palsy patients. Materials and Method : Between July 2008 to July 2010, among patients with chief complain of hoarseness and aspiration, only who were diagnosed as unilateral vocal cord palsy under laryngoscopy, were selected. The patients included 3 females and 13 males age range between 29 to 79 and average age was 60 years old. Results : The hoarseness range were $8.94{\pm}0.77$, $4.63{\pm}1.02$, $4.31{\pm}1.30$ statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Also aspiration were $7.44{\pm}2.48$, $3.63{\pm}1.82$, $3.19{\pm}1.91$ statistically improved during the same period. The result of voice analysis showed that the frequency range shows decrease at 1 week and 3 months after the injection compared to that of the preoperative result in both male and female group (Male: $161.63{\pm}32.78$ Hz, $139.13{\pm}30.63$ Hz, $146.67{\pm}34.20$ Hz ; Female: $244.62{\pm}26.62$ Hz, $244.91{\pm}42.03$ Hz, $237.50{\pm}38.95$ Hz). The Maximal phonation time were $2.75{\pm}1.06$ (sec), $8.88{\pm}3.46$ (sec), $8.44{\pm}3.71$ (sec) statistically showing significant postoperative improve at preoperative, 1 week and 3 months. Conclusion : Injection laryngoplasty with CaHA in unilateral vocal cord paralysis is very safe and efficient procedure to improve a voice disorder, a swallowing difficulty, and a quality of life for those patients with a sacrificed RLN, a cancer invasion of the nerve, and a prolonged vocal cord paralysis which is more than six to twelve months.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.25 no.2
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• pp.96-98
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• 2014

Injection laryngoplasty is simple and useful procedure in patient with vocal cord paralysis even under local anesthesia. For approaching vocal cord level, flexibility of neck mobility is required to operate injection laryngoplasty but it is relatively difficult to approach vocal cord in patient who has cervical fixations. Laryngeal mask airway (LMA) can be helpful:We use a LMA (I-gel$^{TM}$) during intubation without neck extension on flat supine position under general anesthesia and have a good operation filed. LMA with swivel connector give surgeons better surgical vision and make insertion of fibroscope easily during operation. Hyaluronic acid injection was done use needle (25 G, 5 cm) via percutaneous cricothyroid space : This procedure can be useful method for patients who suffer from not only weak voice but also dysphagia and aspiration high vagal palsy patient after spine surgery or uncooperative with awake injection laryngoplasty.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.31 no.2
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• pp.49-55
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• 2020

Evaluating the patient's voice before thyroidectomy is useful for the purpose of identifying patients with vocal cord paralysis without symptoms, identifying other patient's voice abnormalities, and whether it is related to voice disorders that may occur after surgery. Also voice evaluation after thyroid surgery is helpful in diagnosis, treatment, and rehabilitation and follow-up of voice disorders that occur without clear nerve damage after thyroidectomy. And it is helpful for rapid recovery through active early rehabilitation treatment for patients who complain of speech impairment without paralysis. In particular, neck exercise can improve the adhesion of the surgical site and increase the range of motion of the neck as well as improve subjective neck discomfort. In addition, hearing, voice and breathing functions should be improved, and voice hygiene education and counseling should be provided. Vocal cord injection is the first treatment option for unilateral vocal cord palsy. By establishing a protocol for voice disorders before and after thyroid surgery and providing appropriate treatment, the quality of life of patients can be improved.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.141-143
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• 2015

Ortner's syndrome is a rare clinical entity with hoarseness attributable to recurrent laryngeal nerve palsy in cardiovascular diseases. The mechanism of this condition is thought to be due to compression of the recurrent laryngeal nerve by a dilated, tense cardiovascular structure against its adjacent tissue; thus, this is also known as cardio-vocal syndrome. We experienced the case of a 81-year-old female suffering from hoarseness due to a large aneurysm of the aortic arch, and reviews the literature for possible cardiovascular causes of Ortner's syndrome.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.1
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• pp.28-33
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• 2019

Background and Objectives : Laryngeal electromyography (LEMG) is valuable to evaluate the innervation status of the laryngeal muscles and the prognosis of vocal fold paralysis (VFP). However, there is a lack of agreement on quantitative interpretation of LEMG. The aim of this study is to measure the motor unit action potentials (MUAP) quantitatively in order to find cut-off values of amplitude, duration, phase for unilateral vocal fold paralysis patients. Materials and Method : Retrospective chart review was performed for the unilateral VFP patients who underwent LEMG from March 2016 to May 2018. Patient's demography, cause of VFP, vocal cord mobility, and LEMG finding were analyzed. The difference between normal and paralyzed vocal folds and cut-off values of duration, amplitude, and phase in MUAP were evaluated. Results : Thirty-six patients were enrolled in this study. Paralyzed vocal fold had significantly longer duration (p=0.021), lower amplitude (p=0.000), and smaller phase (p=0.012) than the normal. The cut-off values of duration, amplitude, and phase in MUAP for unilateral VFP were 5.15 ms, $68.35{\mu}V$, and 1.85 respectively. Conclusion : An analysis of MUAP successfully provided quantitative differences between normal and paralyzed vocal folds. But, additional research is needed to get more available cut-off value which is helpful to evaluate the status of laryngeal innervations.

• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.2-14
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• 1983

Complications and sequelae of the laryngeal trauma are respiratory difficulties, edema or swelling, cellulitis or abscess, fistula, perichondrium and chondritis, chronic laryngeal stenosis, vocal cord paralysis, decannulation difficulty, and impaired voice production etc. Generally, the treatment of laryngeal injuries consists of initial tracheostomy for adequate airway and later surgical intervention for its complications and sequelae. Recently, authors experienced a case of closed laryngeal injury with thyroid cartilage fracture, left vocal cord paralysis, swallowing difficulty and right clavicular fracture owing to automobile accident. With reconstructive surgery for thyroid cartilage fracture, we established an adequate airway, improved swallowing function and better voice production.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.409-412
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• 1993

We report a case of subglottic stenosis by blunt neck trauma. Preoperative CT showed a stenosis extending distally from just below the vocal cords for 4cm. Concomittent bilateral vocal cords paralysis and quadriplegia were present. At operation the lesion was severely adhesed and the lumen was nearly obstructed. The recurrent laryngeal nerves were embedded in fibrous tissue and were not identified at ease. The stenosed segment was resected and direct end-to-end anastomosis with preservation of the recurrent laryngeal nerves was performed. Six months latar he discharged with intermediate position of vocal cord paralysis.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.30 no.2
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• pp.139-141
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• 2019

The causes of vocal cord paralysis include iatrogenic injury during thyroid or cervical surgery, heart and chest surgery, and tumorous lesion such as laryngeal cancer and lung cancer. In addition to these common causes, rarely, cardiovascular disease can also cause vocal fold paralysis. A disease known as Cardiovocal syndrome, or Ortner's syndrome, causes left vocal fold paralysis when the left recurrent laryngeal nerve is compressed by the pulmonary artery and aorta, which is occurred by pulmonary hypertension from heart disease. We report for the first case in Korea the diagnosis of vocal fold paralysis caused by Ortner's syndrome.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.17 no.2
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• pp.111-114
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• 2006

Objective : The anterior approach to the cervical spine now selves as the surgical across of choice for cervical spine disease. Vocal cord paryalysis(VCP) follow the procedure as a complication, and it is most common complication of this procedure. However, the frequency and etiology of this injury are not clearly defined. This study was performed to establish the clinical features of vocal cord paralysis in anterior cervical spine surgery(ACSS). Material and Method : Retrospectively, medical records of patients who underwent ACSS at Hallym university medical center, Hangang Sacred Heart Hospital between January 2000 and March 2006 were reviewed. Further detailed review of the patients with documented VCP after surgery was then performed. Results : 242 ACSSs were performed and 9 patients with VCP were identified (3.71%) In 9 patients with VCP, 8 patients had right-sided approaches (6.01%) and 1 patient had left-sided approach (0.91%). All 9 patients had VCP on ipsilateral side and 8 patients were recovered completely on follow up period. Duration of ACSS, multilevel exposure and low-level (below the C6 level) exposure have been found to be associated with higher risk. Conclusion : For avoiding the recurrent laryngeal nerve injury, surgeon have to understand the clinical features of VCP in ACSS. As right-sided approach has a greater risk of recurrent laryngeal nerve injury, we suggest that the left-sided approach be given more consideration.

• Journal of Chest Surgery
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• v.50 no.5
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• pp.391-394
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• 2017

Recurrent laryngeal nerve injury can develop following cervical or thoracic surgery; however, few reports have described intraoperative recurrent laryngeal nerve monitoring. Consensus regarding the use of this technique during thoracic surgery is lacking. We used intraoperative recurrent laryngeal nerve monitoring in a patient with contralateral vocal cord paralysis who was scheduled for completion pneumonectomy. This case serves as an example of intraoperative recurrent laryngeal nerve monitoring during thoracic surgery and supports this indication for its use.